Talk:Anal fissure

facts needing confirmation

newly added 9/29/08 - Need a peer reviewed medical journal citation showing that a "common" cause of anal fissure is "excessive anal intercourse".

There are so many dubious statements in this article it's got me really questioning much of it. I'm not an expert but I'm pretty sure that at least half of the following is wrong or misleading:

Anal fissure .... is usually shallow (less than a quarter of inch or 0.64 cm deep). (ES: i'd have thought less than this but not sure)

Causes: Various causes of this fissure include:... ... *severe and chronic diarrhea (ES: really??)

• Crohn's disease (ES: chron's causes fistulas which are quite diferent from fissurs... so dunno about fissure)
• spastic tight sphincter muscles

Anal fissure is common in women after childbirth and in infants.... (ES: i don't think so. after childbirth women may suffer lacerations that may involve the anus but these aren fissures!)

Prevention: In infants under one year old, frequent diaper change can prevent anal fissure. For adults, the following can help prevent fissure: (ES: that may prevent nappy rash!!! a very different thing) ... *Treating diarrhea promptly ... (ES: this is very dubious)

• Using a moist wipe instead of perfumed and harsh toilet paper. (ES: this may help but not really sure)
• Keeping the anus dry and hygienic. (ES: this may help but not really sure)

Treatment: Anal fissures in infants usually self-heal without anything more than frequently changing diapers. (ES: this whole anal fissure in baby thing seems very odd... and again the management would be treating the constibpation and analgesia... not diaper changes)

Deep fissures, ... surgery ... (ES: I think this whole section sounds out of date and needs verification)

Erich 06:32, 11 Jan 2005 (UTC)

References

On diarrhea as a possible cause of anal fissure:

"In adults, fissures may be caused by constipation, the passing of large,
hard stools, or by prolonged diarrhea." MedlinePlus - Anal Fissure

"Other causes of a fissure include diarrhea and inflammation of the 
anorectal area." ACRS - Anal Fissure

On anal fissure, childbirth & Crohn's disease:

"Anal fissures are also common in women after childbirth and 
people with Crohn's disease." MedlinePlus - Anal Fissure

"Fissures can also be caused by anal trauma, laxative abuse, 
childbirth trauma, or laceration by a foreign object." McKinley Health Center - Anal Fissure

On prevention:

"To prevent anal fissures in infants, be sure to change diapers
frequently." MedlinePlus - Anal Fissure

To prevent fissures at any age:
   * Keep the anal area dry
   * Wipe with soft materials or a moistened cloth or cotton pad
   * Promptly treat any constipation or diarrhea
   * Avoid irritating the rectum
MedlinePlus - Anal Fissure

On anal fissure in infants:

"Anal fissures are extremely common in young infants but may occur 
at any age. Studies suggest 80% of infants will have had an anal 
fissure by the end of the first year. Most fissures heal on their 
own and do not require treatment, aside from good diaper hygiene. 
However, some fissures may require medical treatment."
MedlinePlus - Anal Fissure

Hfwd 22:26, 11 Jan 2005 (UTC)

geez it still seems odd to me... but there you go... sorry to have troubled you! Erich 07:21, 12 Jan 2005 (UTC)

Diarrhea

It doesn't have to be a series of diarrhea events that cause the fissure. One, large, fast moving bowel movement of diarrhea is enough to cause a fissure. Obviously you've never had Mexican food before.

LMFAO 216.165.151.101 (talk) 21:10, 29 September 2008 (UTC)

Medical mx

doi:10.1111/j.1572-0241.2007.01203.x reviews non-surgical approaches. JFW | T@lk 15:23, 26 April 2007 (UTC)

All looking forward to reading article having read the intro abstract - except it is by subscription only - shame, was wondering what is best GTN oint or the more recently introduced diltiazem oint (and again both of these vs botox injection - ouch!) :-) David Ruben ^Talk 16:03, 26 April 2007 (UTC)

With botox, no more anal wink. JFW | T@lk 04:21, 27 April 2007 (UTC)

What, no picture?

C'mon. --Adam Corolla Actually, seriously. What does one look like? I was wondering myself to see if what I have is fissures or just Hemroids. Could we have at least one? ~m0u5y —Preceding unsigned comment added by 75.15.223.94 (talk) 23:15, 21 August 2008 (UTC)

Go see a doctor.--131.111.236.123 (talk) 18:01, 23 October 2008 (UTC)

Very much THIS. If you do manage to stare at your own anus through mirrors, or trickery, I'd recommend against making your own diagnosis, god forbid treatment.--Evilbred (talk) 13:10, 23 March 2010 (UTC)

Along with the masturbation article, this is just one of those Wikipedia articles that does not need a picture - animated, photographed or otherwise. MisplacedFate1313 (talk) 06:18, 5 March 2009 (UTC)

Well, it has a picture now, and masturbation has several :O Zoombus (talk) 01:50, 21 December 2010 (UTC)

Really

"Stop excessive anal fisting is a must"...also any objects inserted must be attended too. —Preceding unsigned comment added by 209.86.226.13 (talk) 03:38, 6 February 2009 (UTC)

Agreed, who's to say how much is truly excessive?--Evilbred (talk) 15:45, 13 September 2011 (UTC)

Cause

Fissures have been caused by taking iron pills which make the stool very hard and large.

I dont think u should've said "stool"...  — Preceding unsigned comment added by 173.168.120.77 (talk) 05:53, 6 July 2011 (UTC) 

Prevention

As per WP:MEDICAL, should this section be here at all? --King Öomie 21:14, 28 October 2009 (UTC)

I think it's okay. The medical disclaimer just says, don't take anything on Wiki as actual advice. It's okay to have information on prevention techniques, as long as it's not written like, "You should do this to prevent anal fissures" 71.113.32.33 (talk) 03:44, 21 July 2010 (UTC)

Poor diagnosis by general practitioners?

Many years ago I developed an anal fissure. The diagnosis from a general practitioner: hemorrhoids (I also had to a small extend hemorrhoids but in retrospect that was not the cause of the bleeding and the itching I had). Recently it became acute. Diagnosis from another general practitioner in another country: internal hemorrhoids. Given the fact that I had severe pain for 12 hours after defaecation during 2 weeks I demanded referral to a specialist (not easy in my country: the Netherlands). The general practioner referred me for a rubber band ligation. The surgeon, after hearing how much pain I had (the nurses were worried) suspected the acute anal fissure. So he checked it out by letting me sit on my knees and elbows and confirmed this. He explained that general practitioners often misdiagnose this as hemarrhoids, partially because the patient has to sit in this not so pretty way in order to observe the fissure. It is NOT my intention to share my personal story, I only put it down here with the intention that if other people have the same experience we should add a section to the article about the unability of many general practitioners to diagnose this problem.

82.170.40.166 (talk) 00:47, 13 November 2010 (UTC)

Recent review articles

[1] Doc James (talk · contribs · email) 21:14, 5 April 2011 (UTC)

Incorrect reference about anal dilation removed.

I have removed the reference in support of the clam that "Anal dilation... has fallen out of favour in recent years, primarily due to the perceived unacceptably high incidence of fecal incontinence."

The source does state that "undue anal stretching or other damage to the sphincter can have devastating effects on fecal con- trol." However, this statement is made in the context of spreading the anus in order to surgically remove fissures and warts. It does not apply to anal dilation as a treatment method.

Source removed: Kotlarewsky, M.; Freeman, J. B.; Cameron, W.; Grimard, L. J. (2001). "Anal Intraepithelial Dysplasia and Squamous Carcinoma in Immunosuppressed Patients" (PDF). Canadian Journal of Surgery (Journal Canadien de Chirurgie) 44 (6): 450–454. PMID 11764880. http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/cjs/vol-44/issue-6/pdf/pg450.pdf. Retrieved 2009-05-12. 

Anal Sex: causing fissues a myth?

I once read a study claiming people who partake in anal sex don't have a remarkably higher incidence of fissures than those who don't. I wish I can say I was able to find the source of this study but I cant. It said it's often just confusion over the causation of the fissure, which one would intuitively think anal sex is but usually isn't, as most people who have both fissures and anal sex also have digestive troubles which would lead to a fissure. If anybody can find a source regarding this, please do add it and change the article as needed. — Preceding unsigned comment added by Lerikson (talk • contribs) 07:40, 9 February 2012 (UTC)