About Anal Fissures:
Anal Fissures are small tears that occur when an individual passes large amounts of hard stools. The hard stools tear the sensitive anal mucosa and cause spasm of the anal sphincter. This results in severe pain and bleeding while passing bowels. Anal Fissures are quite common and basically seen in infants although people of any age can get it.
Anal Fissure is a benign condition and in majority of the cases heals by following some lifestyle remedies. However, in some cases when these changes are ineffective, then medical intervention in the form of medications and even at times surgery is the route taken by physicians to treat anal fissures.
Anal fissures are normally of two subtypes; namely primary and secondary. Majority of the cases of anal fissures are primary and therefore quite harmless. However, there have been some cases of secondary anal fissures noted too. Secondary anal fissures require aggressive treatments and are believed to indicate an underlying pathological condition which may be quite serious. Since anal fissures are quite harmless, people often ask whether treatment is really required. This article highlights what may happen if anal fissures are not treated.
What Happens if Anal Fissure is Left Untreated?
Constipation: If anal fissures are left untreated, a host of complications can occur, which may further aggravate the picture and require aggressive medical management. The most common complication that occurs from untreated anal fissure is constipation.(6) An individual with constipation is more likely to pass extremely hard stools when he defecates. This increases the chances of further injury to the anal mucosa and triggers anal sphincter spasm thus aggravating the already existing anal fissure.
Acute Pain: Another complication that arises from untreated anal fissures is the increased intensity of the pain.(6) The individual will have such severe pain that he or she will find it hard to defecate even if the urge is there.
Skin Tags & Anal Fistulas: Untreated anal fissures also may lead to development of skin tags and anal fistulas, which may be difficult to treat and ultimately a surgery may have to be done.[2, 6]
Post-Surgical Complications of Anal Fissures
If an individual undergoes surgery to treat anal fissures then also there are a variety of complications that can occur. These include urinary retention which is quite rare, but definitely possible. Bleeding and abscess formation is yet another complication that can result from a surgical procedure for anal fissure.
Fecal incontinence is also quite a common complication that an individual undergoing surgery for anal fissures may have to deal with along with gas.(3, 5) In rare cases an untreated anal fissure has go on to develop into cancer due to anorectal fistulas that form when this condition remains untreated.
The primary treatment for anal fissures begins with medical treatment where nitroglycerin rectal ointment is prescribed to apply on the affected area for a couple of weeks.(4) If there is no improvement in the symptoms then antihypertensives in the form of Procardia may also be given.
If both of these treatments fail, then Botox injections are given to the anal sphincter to relax the muscles and stop the spasms thereby calming down the symptoms. Surgery is recommended in cases where all the above mentioned treatments are deemed ineffective in treating the symptoms of anal fissure.
In instances where an individual is diagnosed with secondary anal fissure, then surgical treatment is not undertaken until the underlying pathology causing the fissure is identified and treated successfully.
Conclusion: To Treat Or Not To Treat Anal Fissure?
In conclusion, based on the above article it can be safely said that anal fissure is not a condition that should be left untreated, as it invites a host of complications. This is despite the condition being harmless and posing no threat to the body. An untreated anal fissure may lead to constipation, severe pain and development of skin tags and fistulas.[1, 2]
If these occur, then the treatment of anal fissures becomes complicated and ultimately the patient may need surgery to not only treat the fissure, but also to remove the complications such as tags and fistulas. Thus, it is highly advisable to treat anal fissures in the budding stage itself to prevent any unwarranted complications.[1, 2]