Fisher Disease : A Painful Misnomer

Anal Fissure or Fissure-in-ano is a small crack or tear in the opening and lining of the anus. Written as ‘fisher’ by many because of an error in spelling, this rather painful condition has taken the name of ‘Fisher disease’ among many Indians.

An anal fissure occurs because of various reasons that include:

A) Passing hard stools – Lack of high-fibre diet , low water intake, constipation are the possible reasons that can cause hard stools.

B) Straining during childbirth – trauma to the skin between the posterior vagina and the anus medically known as perineum can potentially cause a tear in the delicate skin of the anus.

C) Repeated episodes of diarrhoea – Repeated perks of diarrhoea can also lead to anal fissure.

D) Due to medical procedures : The insertion or various medical devices for diagnosis eg: Endoscope, Rectal Thermometer, enema tip can result in a trauma causing fissure .

Types of Anal Fissure: There are two types of anal fissures

1. Acute Anal Fissure : Acute anal fissures occur suddenly and potentially heal within a time span of 2 weeks. They are associated with tremendous pain. These type of anal fissured can be treated with medicines and cream .

2. Chronic Anal Fissure : Chronic anal fissure generally fail to heal within the time span of 8 to 9 weeks and can worsen the case by reducing the diameter of the anal opening by half centimetre (½ cm) due to which there are chances of recurrence of the fissure every time the patient passes out the stools.

Signs and Symptoms of anal fissure :

Usually the diagnosis of anal fissure can be really easy just by asking your self few of the following questions –
1. Do I have a burning sensation or a sensation which makes me feel as if a sharp subject is pricking me ?
You will have burning pain when you pass stools because of the tear.

2. Am I bleeding from the bottom ? Is the blood bright red in colour?
The bleeding may be caused due to the tear in the anal canal due to which the blood may be fresh blood streak on the stools or on the tissue paper.

3. Do you feel like itching around the anus (medically termed as pruritus ani) ?
You may have an itchy feeling and this is one of the commonest symptoms associated with a fissure.

If you think you have a fissure you can try some of the following tips and preventive measures :

1. Use some Vaseline jelly or liquid paraffin before you go to pass your stools .

2. Try using some laxative.

3. Have a high fibre diet and increase you water intake to a min of 3 litres and reduce intake of spicy food.

4. You can use some stool softeners. I would recommend Constac powder which contains all natural laxatives which are digestive in nature with no side effects.

5. If you have a lot of itching, try Anoac cream which is very effective on fissures.

6. Ignore using tissue and replace it with a shower or gently dab with wet wipes. The reason we suggest not to use a tissue is because it is abrasive and rough on the skin.

7. When you are passing stools , take it easy and go slow , as in many situations letting it go fast can aggravate the fissure.

These above tips can help you in taking care of an acute fissure. However, in case of a chronic fissure or an acute fissure that shows no signs of healing, it is wise to visit a Proctologist and avail good treatment at the earliest.

For an appointment with leading Proctologist, Dr Ashwin Porwal click here .

For more information and treatment for fissures you can click here

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