DESCRIPTION
* This is a cut (ulcer or laceration) inside the anus. The usual cause is Trauma to the anus because of a strained bowel movement, a hard bowel movement, or high internal sphincter tone (the area that allows stool to pass stays too tense to allow proper passage).
SYMPTOMS
* Severe tearing pain during a bowel movement
* Throbbing pain in anus following a bowel movement
* Blood on toilet paper or around the bowel movement
CAUSE
* Constipation
* Straining
* High internal sphincter tone (explained above)
HOW THE DIAGNOSIS IS MADE
* Visual inspection by physician
* Tests:
1. Anoscope
2. Flexible sigmoidoscopy
TREATMENT
* Sitz baths (baths in a warm tub of water)
* Fiber supplements
* Stool softeners
* Topical anesthetics (Mesalamine suppositories)
* Topical nitroglycerin ointment (at 10% of the strength used for angina) -- relaxes the internal sphincter
* Partial lateral internal sphincterotomy or excision of the fissure
SIMILAR CONDITIONS
* Thrombosed external hemorrhoid
* Solitary rectal fissure
* Cancer of the anus
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