Anal Fissure

I’ve mentioned anal fissures before on this blog. These are breaks in the anal skin caused by passage of hard stools. They are also caused by tight anal sphicters (anus control muscles). The tight sphincter causes blood supply to the skin breaks to be reduced and this prevents proper healing of the anal skin. It’s a vicious cycle of tight sphincter… anal fissure…. pain…. tighter sphincter… more anal fissure… more pain…..

Are fissures dangerous? Well, they cause a lot of pain. They sometimes bleed, but it’s never a lot. I’m going to break the rule of “never say never or always” and say that it always stops by it self and is more scary than dangerous. The problem is in differentiating a simple fissure from other more dangerous causes.

Having said that… don’t you think that the potential pain is bad enough to motivate poeple to prevent it?

Now, this is an acute fissure.. one which had been there for a short while only. This is caused by the passage of hard motion. It should heal if pain is controlled and the motion is softened.

OK… in case you don’t see it, the fissure is in the 7 o’clock position (similar to the face of the clock).

This is a colonoscopy picture. It was not done to diagnose fissures… the diagnosis can be made by examination alone.

So keep your motion soft. Take enough fibre and practice good toilet habits. I can never say this too much.

23 comments so far

  1. hoiling March 29, 2007 12:19 am

    Yes Sir!! Will time my toilet ritual accordingly! ;)

  2. Bernard March 29, 2007 12:32 am

    Aiks! hoiling, no no… wrong message! wrong message! DON”T time your toilet visits…. I shouldn’t have put the clock there. LOL.

    … good toilet habits mean going when you need to and leaving once you’ve finished.

    … going by the clock is NOT helpful. In fact, that’s the recipe for haemorrhoids.

    … Of course if nature happens to call at the particular time everyday then it’s fine.

  3. hoiling March 29, 2007 12:47 am

    hahahah .. relax doc, relaxxx. I’m making fun with your pressure-clock there! hehehee

  4. Bernard March 29, 2007 1:08 am

    hoiling, phewww!! you got me worried there!

  5. Jean-Luc Picard March 29, 2007 2:52 am

    Err…time to move on…

  6. simple american March 29, 2007 4:46 am

    O_0

    *pengsan*

    *plop*

    (Note great caution was made not to faint on my arse)

  7. jonzz March 29, 2007 8:52 am

    Alamak, so many ‘burst’ arse pictures. Is that the majority of your surgery types these days, LOL!

  8. Samm March 29, 2007 9:34 am

    Aighhh. if only ppl so discipline lohhh. More fruits and veges and practise good toilet habits woh. If dats the case, then there wouldnt be so many constipated souls out there.

    And also, hoh. I tagged you from my health blog. DOnt get the url wrong, hoh…

    To Japan i will go

  9. Samm March 29, 2007 9:35 am

    And thx for linking me :)

  10. Giddy Tiger March 29, 2007 9:39 am

    Nature is calling as I skim through them pictures up there, doc.
    :P

    By the way, I just tagged ya…

  11. Bernard March 29, 2007 10:36 am

    Capt Picard, to go where no man has gone before.

    SA, ahhh.. yes.. be careful. Better if you could sit down first … then faint. ;-)

    jonzz, the bottom end is easier to handle than the top end. Think so? ;-)

    Samm, okkk! I’ll be doing that soon. Thanks for linking.. I’m getting giddy with all your blogs. Haha. Good thing you warned me about getting the correct the url.

    Giddy Tiger, aiks.. the same tag as Samm’s! Haha… two birds with a stone.

  12. LM March 29, 2007 2:19 pm

    one of the best fibers is sweet potato. stools come out nicely shaped, soft like sausage! :P veggie and fruit fiber irritates my bowels and eatting too much will lead to soft/watery stools.

  13. […] - Dr. Chan on anal fissures […]

  14. pelf March 29, 2007 7:28 pm

    Err.. Doc, “good toilet habit” means WHAT?

    I had a housemate who never flushed after pooping. That’s BAD toilet habit, no? Hhahaha :)

  15. Firehorse March 29, 2007 8:46 pm

    As per your instruction I go take psyllium right now.

  16. sbanboy March 29, 2007 9:15 pm

    Looks painful …… ouch !!!!!

    Ok I will take my time in the toilet ……. ooppss I might be late for work then …. hmmmm dilemma

  17. Ah Pek March 30, 2007 11:38 am

    oh no!! not the see fatt lung again!!

  18. Bernard March 30, 2007 11:50 am

    LM, thanks for the tip rooted in experience. :-)

    Pelf, kakakaka… that’s BAD toilet etiquette as well, eh!

    What I mean by toilet habit is the habit of when and how we open our bowels:

    • Go when there’s an urge, not before and don’t delay if possible
    • Do not go by the clock. The rectum doesn’t wear one.
    • If your urge comes at a certain of the day, everyday, then that’s fine
    • etc…I’ll elaborate later.

    FireHorse, only if you’re having hard stools.

    Sbanboy, hahaha.. actually spending too much time in toilet is DEFINITELY NOT a good habit. Just do it and leave. LOL.

    Ah Pek, have you heard the story of the see fatt lung clamming up, huh, huh? … it’s the taikor!

  19. Bengbeng March 30, 2007 2:36 pm

    what is your opinion of Hor Yan Hor chinese herbal tea for softening stools and regulating bowel habits

  20. eastcoastlife March 30, 2007 2:41 pm

    eeks… most times I come here, have to tolerate all these photos. But good education la, cannot complain too much. wat to do, I have no backbone, still want to come. Lidat must see wat doctor huh? hahaha…..

  21. Chelsea April 2, 2007 4:49 pm

    But often the symptom of bleeding when passing motion can be haemorrhoids too right??? How to differentiate?

  22. Rick December 18, 2007 6:55 am

    I have solved my own anal fissure simply by the way I sit on the toilet. I had a fissure for about 6 months. I realized that I arched my lower back which caused the colon to “arch”. When I round my lower back out, the bowel exits out more straight versus scraping/rubbing against the posterior part of the colon/sphincter. As soon as I started doing this, the fissure was gone in a week or so…so the trick (at least for me) was to round the lower part of my back (like the scared cat position in yoga but instead the lower back). Hope this helps some of you!

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