Anal Fissure

Anal fissure refers to a small cut or tear in the skin lining the anal canal. Anal fissure can occur to people of any age group, including infants. Hard and dry fecus tends to tear the anal lining leading to a fissure. Anal fissure can also be caused due to inflammation in the rectal area. In some cases, anal fissure can be caused due to anal cancer, Crohn's disease, viral infections or HIV. Symptoms of anal fissure include blood in the stools and extreme pain during bowel movement. A fissure in the anal canal can be observed during a physical examination. Endoscopic examination helps in ruling out any serious conditions of the anus and rectum.

Most anal fissures heal without surgery. A patient suffering from anal fissures must avoid constipation by following a high-fiber diet and drinking plenty of fluids. Stool softeners are often resorted to. Medicated creams are prescribed to aid healing of anal fissures. Surgery is rarely resorted to. Surgery may reduce pain and promote speedy healing.

Hemorrhoids

Hemorrhoids or piles are caused when the veins around the anus or lower rectum get swollen and inflamed. Hemorrhoids are painful but surely not dangerous or life threatening. Hemorrhoids are very common among pregnant women. The pressure of the fetus on the abdomen and hormonal changes affect the blood vessels and force them to enlarge. These vessels experience severe pressure during childbirth thereby making hemorrhoid a common occurrence in women.

Causes for hemorrhoids

• Straining too much to pass stools
  
• Sitting for too long
  
• Chronic constipation
  
• Pregnancy
  
• Childbirth
  
• Obesity
  
• Cigarette smoking
  
• Excessive coughing
  
• Aging
  
• Diarrhea
  
• Anal intercourse
  
• Hypertension
  
• Lifting heavy weight
  
  

Types of hemorrhoids

Internal hemorrhoids: Veins that get swollen inside the anal canal are referred to as internal hemorrhoids. Internal hemorrhoids are not very painful as there are no pain receptors in this area. Most people who have internal hemorrhoids are not even aware. Internal hemorrhoids can bleed when they are irritated.

External hemorrhoids: Veins that get swollen near the opening of the anus are termed as external hemorrhoids. These hemorrhoids are at times painful and cause swelling and irritation.

Anal fissure: A thin tear in the anal area is an anal fissure. This hemorrhoid is itchy, painful and bleeds while passing stools.

Prolapsed hemorrhoids: These hemorrhoids are a type of internal hemorrhoid and they stretch down until they protrude outside the anus. This type of hemorrhoid can be painful.

Thrombosed hemorrhoids: A blood clot forms inside the external hemorrhoid thus causing thrombosed hemorrhoid. This type of hemorrhoid is very painful and can be felt as a stiff but tender mass in the anal area.

Typical symptoms of hemorrhoids include rectal pain and itching. There might bleeding during bowel movements. Increase fiber and fluid intake to avoid constipation. Use ice packs for relief. Use hemorrhoidal cream. Tub or sitz baths can provide relief. Exercise regularly and wear loose undergarments.

Common techniques followed in removal of hemorrhoids

Hemorrhoidectomy: At times severe internal or external hemorrhoids may require removal by surgery; this procedure is known as hemorrhoidectomy.

Sclerotherapy: A chemical solution is injected around the blood vessel so as to shrink the hemorrhoid.

Rubber band ligation: A rubber band is positioned inside the rectum around the bottom of the hemorrhoid. The band helps in cutting off blood circulation thereby forcing the hemorrhoid to wither away after a few days.

Infrared coagulation: A special device is used to burn hemorrhoidal tissue.

Laser coagulation: This is a new technique - electric current is applied to remove the hemorrhoids.