Anal Fissure Flashcards
1
Q
define an anal fissure?
A
- a painful tear in the squamous lining of the distal anal canal
2
Q
where are anal fissure often positioned?
A
- posterior
3
Q
how to catagorise anal fissures?
A
- acute = less than 6 weeks
- chronic = more than 6 weeks
4
Q
epidemiology of anal fissures?
A
- affects 1/10 people
- both sexes equally affected
- occurs often in young adults
5
Q
what are the risk factors of anal fissures?
A
- mostly caused by constipation
- rare causes are STIs, trauma, crohns, anal cancer, psoriasis
6
Q
what are the presenting symptoms of an anal fissure
A
- tearing pain when passing stools
- painful bright red rectal bleeding
- anal itching
7
Q
what are the signs of an anal fissure on physical examination?
A
Tears in the squamous lining of the anus on examination
8
Q
what are the investigations for anal fissure?
A
- examine the anus
9
Q
what is the management plan for anal fissures?
A
- acute fissure=
- soften the stool with diet and laxatives
- lubricants
topical anaesthetics
analgesia
chronic fissure =
- GTN ointment
- if not effective refer for surgery (sphincterotomy) or botulinum toxin.
10
Q
what are the possible complications of anal fissures?
A
- chronic anal fissures
11
Q
prognosis for patients with anal fissures?
A
- in most people the fissure will heal in a week or so
- good prognosis
