You know, many people don’t give any consideration to the rather obstreperous little part of their bodies called the anus. Without it, where would all of our waste go? There is only an small amount of waste that can be excreted through sweat and urine. Furthermore, without the need for bowel movements many of us would fall way behind in our reading. Trust me, I know! Well, since the anus is so important to us, isn’t it only normal to take considerable care of such a sensitive area? It is, and I’m here to tell you how. More specifically, I’m here to inform you about a vexatious little malady called the anal fissure. An anal fissure is a tear or ulcer in the anal lining, or anus mucosa, that can cause pain and/or bleeding upon defecation. To make it easier for the reader, I have divided this node into several categories: causes, signs and symptoms, risk factors, prevention, diagnosis and treatment, medication and additional information. Let’s start with causes.

          Contrary to popular belief, there are vast and varied reasons why one might experience an anal fissure. The most common way to get an anal fissure is to over stretch the anal wall by the excretion of large, hard stool. Other ways to get anal fissures are by tightening the anal canal with an excess of tension causing the skin to break, having the anal lining stretched by conditions such as pinworms, or by excessive wiping after evacuation. Infants can acquire anal fissures from the irritation of stool in their diapers. Anal fissures are also common to those who frequent the ingression of foreign objects into the anus. You know who you are!

          Anal fissures are very easily discerned, as there are myriad signs and symptoms of the ailment. For instance, there are painful bowl movements with marks of bright red blood on the surface of the feces. This pain associated with the bowl movement often subsides then recurs with subsequent bowl movements, perpetuating the illness. Streaks of blood may also be found on the toilet paper, undergarments, or in the diaper of the afflicted, in the case of infants and incontinent old men. Anal fissures may become chronic, in which the victim may experience periods of exacerbation, where the affected area itches like all get out, and remission, where the pain seems almost nonexistent.

          Anal fissures are most common in infants. In fact, about 80% of infants experience at least one anal fissure during their delicate time period. The risk factor rapidly decreases with age, and they are considered uncommon if you should experience one by schooling age. Being well past the age of infancy does not, however, safeguard you from anal fissures. You still need to be aware of the additional risks that lead to the onset of them. First of all, there is constipation, the most common risk. Leukemia, Crohn’s disease, and repetitive use of laxatives can also cause fissures. Anal fissures have recently been associated with immunodeficiency disorders, like AIDS. Anal fissures may also be the result of multiple pregnancies -- this is for all you promiscuous women out there, you know who you are!

          Right about now you may be thinking to yourself, “Hey, goober, with so many ways to get anal fissures, there is no hope for humanity!” And to that I say, “Yes there is goober, yes there is.” To prevent constipation, thus alleviating one of the prime contributors to anal fissures, it is recommended to drink eight glasses of water a day, and eat a diet rich in fiber. Use stool softeners for resilient stool, don’t strain during bowel movements or you might tear yourself a new O-ring. Also, it's probably wise to refrain from anal intercourse. Seek professional treatment for contributing disorders like pinworms and eczema, if needed.

          If it is too late to prevent the anus-annihilating disease, there are many ways to treat it. First, you need to make sure the diagnosis is in fact that of an anal fissure by having the affected area meticulously examined with an anoscope or sigmoidoscope. It is important to rule out any other possibilites that may be causing the anal or rectal bleeding. For mild succor, gently clean the anus with soap and water after each bowl movement. To relieve muscle spasms and pain around the anus, apply a warm towel to the affected area. Sitz baths are also a great method of pain relief. Simply draw eight inches of warm water in a tub, and soak your buttocks for 20 to 30 minutes. If the problem persists, surgery may be necessary to repair the fissure or alter the contracting muscle that prevents normal healing.

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