( By Dr. H.K.Bakhru )
Anal fissure refers to a tiny crack in the skin surrounding the anus, the excretory opening from the bowel. The irritation usually extends down to the muscle fibres. This ailment is quite common in infancy and early childhood and causes a great deal of concern to parents.
Anal fissure is very painful. The child feels a sharp pain while passing motion. The pain may continue for sometime even after defecation. Often the child suppresses the stools to avoid pain. There may be slight bleeding and very often itching round the anus. Any scratching of this area causes intense distress.
The most common use of anal fissure is chronic constipation and the resultant hard motions, which damage the tissue and tear the mucous membrane. Once this has been done, the fissure is reopened at the passage of subsequent motions and further infected by the feaces. The root cause of this disorder, as in case of constipation is, wrong feeding.
As the anal fissure results from chronic constipation, the treatment for this disease is same as for constipation, outlined in chapter 8 on constipation.
The pain of anal fissure can be best relieved by hot applications to the anus. Older children can be made to sit on a pail or jar, half- filled with hot water, while moving the bowels. The hot steam relaxes the sphincter, and exercises a powerful analgesic effect upon the painful tissues. Other helpful measures are hot anal douche with little pressure, fomentation over buttocks and hot rectal irrigation.