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Most anal fissures are caused by stretching of the anal mucous membrane beyond its capability. [3] Superficial or shallow anal fissures look much like a paper cut, and may be hard to detect upon visual inspection; they will generally self-heal within a couple of weeks. However, some anal fissures become chronic and deep and will not heal.
Anal fistula is a chronic abnormal communication between the anal canal and the perianal skin. [1] An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. [2] Anal fistulae commonly occur in people with a history of anal abscesses. They can form when ...
Generally, fissures are due to injury to the mucosa, or because of a poor local blood supply that prevents proper healing, with spasm of the external anal sphincter contributing. [9] The external anal sphincter can be relaxed by the application of glyceryl trinitrate creams, and constipation is managed with laxatives and improving hydration. [ 9 ]
A rectal prolapse occurs when walls of the rectum have prolapsed to such a degree that they protrude out of the anus and are visible outside the body. [2] However, most researchers agree that there are 3 to 5 different types of rectal prolapse, depending on whether the prolapsed section is visible externally, and whether the full or only partial thickness of the rectal wall is involved.
This examination may show anal fissures, prolapsed hemorrhoids, internal intussusception, rectal prolapse, or other anorectal lesions. Patients with occult rectal prolapse may show heperemia and edema of the anterior (front) rectal wall, colitis cystica profunda or solitary rectal ulcer syndrome (blood, mucus, area of erythema and ulceration).
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As such, pain associated with constipation (either chronic, or acute), penetrative anal intercourse, trauma (such as tears or fissures of the rectal sphincter or anal canal), side-effects of some medications (particularly opiates), or rectal foreign body insertion preclude this diagnosis. The pain episode subsides by itself as the spasm ...