Anal Fissure

Reviewed 06/2017
 


BASICS

DESCRIPTION

Anal fissure (fissure in ano): longitudinal tear in the lining of the anal canal distal to the dentate line, most commonly at the posterior midline; characterized by a knifelike tear...

DIAGNOSIS

HISTORY

  • Severe, sharp rectal pain, often with and following defecation but can be continuous; some patients will see bright red blood on the stool or when wiping.

  • Occasionally, anal pruritus o...

TREATMENT

The goal of treatment is to avoid repeated tearing of the anal mucosa with resultant spasm of the internal anal sphincter by decreasing the patient's high sphincter tone and addressing its u...

ONGOING CARE

DIET

High fiber (>25 g/day; augment with daily fiber supplements); increase fluid intake. 

PATIENT EDUCATION

  • Avoid prolonged sitting or straining during bowel movements; drink plenty of f...

REFERENCES

Altomare  DF, Binda  GA, Canuti  S, et al. The management of patients with primary chronic anal fissure: a position paper. Tech Coloproctol.  2011;15(2):135–141. [View Abstract on Ovi...

ADDITIONAL READING

  • Fargo MV, Latimer KM. Evaluation and management of common anorectal conditions. Am Fam Physician.  2012;85(6):624–630.

  • Gee T, Hisham RB, Jabar MF, et al. Ano-coccygeal support...

CODES

ICD10

  • K60.2 Anal fissure, unspecified

  • K60.0 Acute anal fissure

  • K60.1 Chronic anal fissure

ICD9

565.0 Anal fissure 

SNOMED

  • 30037006 Anal fissure (disorder)

  • 197151007 Acute anal fissure (disorder)

  • 19715200...

CLINICAL PEARLS

  • Avoid anoscopy or sigmoidoscopy initially unless necessary for other diagnoses.

  • Best chance to prevent recurrence is to treat the underlying cause (e.g., chronic constipation).

  • No medica...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

 
×