Rectal fissure what to do. Rectal fissure: features of acute and chronic forms. Causes of the defect

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The cause of bleeding from anus, burning and itching in this area occurs not only with hemorrhoids, but also with rectal fissures. Many people do not dare to consult a doctor with such an intimate problem and self-medicate or even let things take their course.

But even minor damage to the anus can lead to serious complications. Read on to learn about the causes of rectal fissures, symptoms and treatment of this problem.

Rectal fissure - what is it?

Rupture of the superficial tissue in anal area- This is a fissure of the rectum. The anus is lined with mucous membrane in its inner part, and skin in its outer part.

A crack can appear anywhere, and most often occurs on the dentate line - the border between the skin and mucous membrane. Its length usually does not exceed 2 cm, and its width is 3-5 mm.

Fissures in the anal area are painful and are often accompanied by bleeding, since the mucous membrane lining the rectum and anus is equipped with many capillaries and nerve endings.

Anal fissures can be acute or chronic. In the first case, the defect has a linear appearance and is often shallow, and in the second, the gap becomes deeper, wider and resembles an ulcer.

Without treatment, after 4-6 weeks, an acute fissure becomes chronic, which often occurs with inflammation of the mucous membrane or skin in the affected area.

Causes of rectal fissures

There are several factors that provoke this problem, and one of them is constipation, or constipation. A rectal fissure occurs when voluminous and compacted feces during defecation injure the walls of the anal area.

Rare constipation forms small cracks that heal on their own within 3-4 days. With chronic constipation, damage to the mucous membrane constantly increases, does not have time to heal and causes severe pain.

Another reason is associated with infectious and inflammatory pathologies of the intestines and rectum in particular. Among them are helminthiasis, proctitis, intestinal polyps.

Anal fissure of the rectum can also appear for the following reasons:

sedentary lifestyle life;
pregnancy and childbirth;
taking laxatives;
haemorrhoids;
anal sex;
Crohn's disease;
leukemia;
syphilis.

At severe diarrhea caused by dysbacteriosis, food poisoning or other factors, anal fissures may also appear. This is due to the fact that during diarrhea, stool often contains substances that are aggressive to the mucous membrane - bile, bacterial toxins.

Symptoms of rectal fissures (photos)

With a fissure of the rectum, the symptoms are brighter, the deeper the rupture of the mucous membrane. The main manifestations are:

pain in the anal area;
burning and itching;
bleeding.

Pain initially occurs during bowel movements, prolonged sitting, cycling, wearing tight underwear, anal sex and other mechanical impacts. With an acute fissure, the pain is stabbing, burning, pinching.

As the mucosal defect increases and as inflammation develops, the pain becomes more pronounced and acquires a nagging character. Swelling appears in the area of the crack, and every trip to the toilet causes unbearable pain.

If bright scarlet blood is released from the anus, this means that the capillaries are damaged. This is usually observed at the initial stage in the acute form. Appearance dark blood indicates damage to the veins - such bleeding is similar to hemorrhoidal bleeding, it is more intense and longer lasting.

Symptoms of a rectal fissure are similar to those of hemorrhoids, polyps or intestinal cancer, proctitis, so do not neglect a visit to a proctologist and a thorough diagnosis.

Diagnosing anal fissures is not difficult. Mucosal defects are usually detected during a proctological examination of the anal and rectal area. In order to differential diagnosis the doctor may prescribe colonoscopy, rectoscopy, ultrasound of the abdominal cavity and pelvic organs, lab tests blood, feces, urine.

In the treatment of anal fissures the following is used:

Local remedies - suppositories and ointments;
Systemic drugs according to indications;
Diet food;
Traditional medicine;
Surgery if the above methods are ineffective.

Local remedies

preparations for the treatment of cracks photo

Ointments and rectal suppositories used for anal fissures have a healing, analgesic and anti-inflammatory effect. Preparations with anesthetics (novocaine, papaverine, lidocaine) effectively relieve pain, and ointments with sea buckthorn oil and methyluracil heal well.

In case of bacterial infection of the wound, it is prescribed local remedies with antibiotics - Proctosedyl or Olestesin suppositories, Levomekol ointment.

When treating rectal fissures, ointments or creams are injected into the anus 1-2 times a day after bowel movements. Most drugs are equipped with an applicator for ease of use. The course of application is from 5 to 10 days.

Examples of ointments are Emla, Dexpanthenol, Actovegin, Aurobin, Ultraproct, Methyluracil ointment, Kategel, Actovegin.

To treat rectal fissures, it is convenient to use rectal suppositories. They are quickly administered, well absorbed, and the oils in their base also have a laxative effect. For large chronic fissures, combined suppositories with analgesic, antispasmodic and anti-inflammatory effects are most effective. The method of using suppositories is the same as for ointments.

Example of suppositories - Relief, Anestezol, Posterizan, Anuzol, Aurobin, suppositories with belladonna, Methyluracil, Procto-glivenol.

Ointments and suppositories for the treatment of rectal fissures have contraindications and side effects, many of them are prohibited for use by pregnant, lactating women and children. Therefore, any drug should be used only as prescribed by a doctor.

In local treatment it is also useful to use warm sitz baths with weak solution potassium permanganate. They help prevent the addition of a secondary infection.

Systemic drugs

Oral medications are prescribed depending on the pathological reasons the appearance of cracks and associated diseases. Among them:

laxatives;
anti-inflammatory drugs;
calcium channel blockers;
angioprotectors;
painkillers;
vitamins and dietary supplements.

For example, with inflamed hemorrhoids and weakness of the venous walls, anti-inflammatory drugs, angioprotectors and drugs that thin the blood and reduce its clotting are indicated.

Diet and nutrition

With rectal fissures, it is important to get rid of constipation, if any, and prevent its occurrence. To do this, the diet should include vegetables and fruits, dried fruit compotes (dried apricots, prunes), and a sufficient amount of liquid.

The first courses should not be neglected. It is necessary to exclude alcohol, coffee, foods that irritate the intestines - marinades, sour, hot and spicy foods.

Surgery for rectal fissure

The operation is indicated if the above-described treatment methods have not brought results within 1.5-2 months. Similar situation usually occurs with chronic cracks that heal poorly and are accompanied by an infectious and inflammatory process in the tissues.

Removal of rectal fissures is often carried out using the following methods:

Excision, in which the dead edges of the wound are removed with a laser or scalpel and sutures are applied to close the crack.
Lateral sphincterotomy - the lateral muscle fibers supporting the anus are partially excised, which reduces tension in the anal area.

During the first 5-7 days after surgery, a person feels pain in the rectal area, which can be reduced by pain-relieving rectal suppositories.

Also on initial stage post-operative recovery follow a strict diet aimed at ensuring that there are no bowel movements for several days. In the future, nutrition should not allow constipation - soups, liquid cereals, fresh fruits and vegetables, smoothies are allowed.

Folk remedies in the treatment of rectal fissures

For long-standing and severe damage to the mucous membrane, as well as wounds caused by any disease alone traditional methods not enough. But for small cracks in the rectum, many folk remedies are effective - sitz baths with herbs, homemade ointments and suppositories.

Sitz baths should be warm, but not hot. They can be made with decoctions of oak bark, chamomile, knotweed, and calendula, which can also be used for douching.

Homemade candles can be prepared like this:

2 tbsp. l. melt cocoa butter in a water bath;
add 2 tbsp. l. a strong decoction of oak bark and motherwort;
When the butter begins to harden, but is still soft, form candles.

A popular ointment based on visceral fat(which must first be melted), propolis and celandine juice. After hardening a small amount of the product (the size of a small cherry) is injected into the anus twice a day for a week.

Rectal fissures during pregnancy

Hemorrhoids and rectal fissures - frequent companions pregnant women. These troubles arise due to stagnation of blood and lymph in the pelvis, constipation, pressure of the uterus on the intestines and are more often diagnosed in the II-III trimesters of pregnancy.

Constipation occurs due to slow intestinal motility, and decreased tone the abdominal and rectal muscles force a woman to strain hard during bowel movements. As a result, anal fissures and hemorrhoids form.

Treatment is aimed at softening feces, pain relief, healing of wounds on the mucous membrane of the rectum and anus. During pregnancy, you can use Natalsid suppositories, propolis suppositories, Microlax laxatives, Duphalac, and calendula ointment. For inflamed cracks, Vishnevsky and Fleming ointments are effective.

It is important to begin treating anal fissures during pregnancy at the first symptoms. This will avoid the development purulent infection and complications during childbirth.

If a rectal fissure does not heal for a long time, then the risk is high heavy bleeding, infectious inflammation and education cancerous tumor. A dangerous complication is paraproctitis and blood poisoning. With timely treatment, the prognosis is favorable.

The disease needs to be treated under the supervision of a doctor, do not be ashamed and do not be afraid to go to the proctologist, because this is first and foremost your health. You should not prescribe therapy on your own, since the symptoms of diseases of the large intestine can be similar. For example, pain during bowel movements occurs both with hemorrhoids, anal fissure, and more severe pathology of the colon. Therefore, you should visit a proctologist to undergo the necessary examination.

Conservative treatment

If the crack exists for a short time, no more than a month, conservative treatment is prescribed. For this, the patient is recommended to use sitz baths, anti-inflammatory and wound healing ointments and candles.

Experts advise doing light physical exercise, walk more, swim in the pool. You should not lift heavy objects.

However, it will be impossible to completely eliminate the disease if you suffer from constipation. After some time, a fissure in the anus may reappear due to the passage of solid stool through the intestines. Therefore, they begin to treat cracks with the organization of nutrition.

Diet - proper nutrition

Its purpose is to establish transit of intestinal contents. To have regular bowel movements, you need to include foods rich in dietary fiber in your meals every day. These are vegetables and fruits bran bread, cereals and legumes.

three fruits;
three servings of vegetables, each serving approximately 100 grams;
4 servings of cereals (buckwheat, oatmeal) and wholemeal bread.

Several times a week you should eat legumes and nuts. Alimentary fiber, on the one hand, they pull water towards themselves, thereby ensuring the formation of soft stools. On the other hand, fiber stimulates the movement of the food bolus through the intestines, resulting in regular bowel movements.

Patients with constipation, which has led to the appearance of a fissure in the rectum, are not recommended to eat white bread, since it clogs the intestines, and you should also not get carried away meat dishes. For cracks, avoid spicy, salty, smoked, pickled foods and alcohol. All these products can cause intestinal irritation and the appearance of stagnation.

Beets, dried apricots, prunes, pumpkin, apricots, and figs have a laxative effect. Juices with pulp from vegetables and fruits can be recommended.

They are prescribed to relieve sphincter spasm, the duration of the bath is 15–20 minutes, 2–3 such procedures must be done per day. Doctors usually recommend adding a solution of manganese to warm water (39 degrees) to disinfect and relieve inflammation.

Traditional medicine treats rectal fissures with decoctions medicinal plants(calendula, chamomile, yarrow). They have anti-inflammatory, analgesic and antispasmodic effects.

Baths should be done after each bowel movement, as well as in the morning and at night. After the water procedure, it is recommended to blot the anal area with a soft cloth, after which you can use ointment or suppositories.

Microclysters

They are carried out in evening time for 2 weeks. To do this, mix a decoction of chamomile and sea buckthorn oil V equal quantities, take 50–60 ml of the product into a syringe and inject it into the rectum. You should retain the liquid in the rectum for as long as possible.

For microenemas you can use the following means:

decoction of chamomile, St. John's wort, oak bark, sage, flax seed in the amount of 50 ml, for preparation you will need 1 tbsp. a spoonful of raw materials per glass of boiling water;
honey water (a tablespoon of honey is dissolved in half a glass of water), injected into the anus;
sea buckthorn oil, rosehip oil or fish fat in an amount of 30 ml;
Solcoseryl in the form of a gel. A tube of medication is dissolved in warm water (30–50 ml) and injected into the intestine before bed. The number of procedures for rectal fissures is at least 10.

Candles and ointments

Of course, it is impossible to treat a disease without local application medicines. For fissures in the anus, the same medications are prescribed as. They are designed to relieve pain and inflammation, reduce sphincter tension, and heal mucosal defects.

Suppositories are administered after defecation and anal hygiene, and a warm bath. You need to use 2 candles per day, preferably leaving one of them in the anus all night.

If ointments are used, they can be administered using a gauze pad soaked in medicine, or applied to a bandage and bandaged to the anus where the fissure is located. Some doctors advise using hygienic feminine tampons for this purpose, but you just need to take the smallest size.

Painkiller suppositories

They usually contain some kind of analgesic, which facilitates painful sensations in the anus. The following funds can be identified:

Anestezol;
Betiol with belladonna extract;
Suppositories with calendula (homeopathic);
Salofalk;
Suppositories with glycerin;
Ultraproct;
Proctoglivenol;
Ichthyol candles.

Wound healing and anti-inflammatory suppositories

They help treat rectal fissures and prevent complications.

Relief (contains shark liver oil, which has anti-inflammatory, hemostatic and analgesic effects);
Suppositories with propolis. They can be purchased at the pharmacy, or you can prepare them yourself at home. To do this, propolis is grated on a fine grater, mixed with butter and melted in a water bath. Then pour into molds and place in the refrigerator to harden.
Methyluracil. Suppositories with this component have a good wound healing effect.
Natalsid. These suppositories do not contain hormones or other harmful substances, therefore can be used to treat cracks in women in postpartum period and during pregnancy.
Posterized. This drug contains inactivated intestinal bacteria, as well as their metabolic products. The product increases immune protection and has an anti-inflammatory effect.
Witch hazel ( homeopathic remedy plant-based);
Hepatrombin G. Suppositories help stop bleeding from a fissure in the anus, have an anti-inflammatory and analgesic effect.

Antispasmodic drugs

To relieve spasms, ointment with nitroglycerin and suppositories with papaverine are used. They help reduce tension in the sphincter muscles, which significantly speeds up the healing of the mucous membrane.

Traditional methods of treatment

They allow you to achieve good results, especially if they are used as additional method to basic drug therapy.

A well-known remedy for the treatment of hemorrhoids and rectal fissures is a potato suppository. The vegetable is peeled and a candle is cut out of it, which is placed in the anus. Potatoes have a local anesthetic effect.
Microenema ointment. Ingredients: hop cones (2 pieces), fish oil (1 tablespoon), aloe juice (1 tablespoon), chicken egg white (raw). You need to prepare a strong infusion from hop cones; to do this, brew them in 1/3 cup of boiling water and leave for 20 minutes. Then mix the infusion with the remaining ingredients. Injected into the rectum in the evening. The course of treatment is one and a half to two weeks.
Candles. To prepare them you will need hop cones (8 pieces), unsalted lard(0.5 kg), St. John's wort (3/4 cup herb), 1.5 cups boiling water. Hops and St. John's wort must be boiled, left for 3 hours, wrapped in a warm cloth. Strain the infusion.

The lard is finely chopped and melted a little in a frying pan, after which the cooked herbal infusion and mix thoroughly, using a blender. The product must be cooled in the refrigerator. Candles the thickness of a little finger are prepared from the frozen mixture and placed in the freezer to harden.

Surgical treatment

It is prescribed for chronic fissures in the anus, which has been bothering the patient for more than a month. The edges of the crack are excised and scar tissue is removed.

A sphincterotomy is often used, which involves making a small incision in the anal muscle. This method allows you to get rid of spasm and prevent relapse of the disease.

One of the diseases with which people are increasingly turning to the doctor is an anal fissure - a rupture or cut in the anal mucosa, which causes discomfort and discomfort to the patient. discomfort. Therefore, the issue of treating and eliminating the symptoms of rectal fissures remains relevant.

Collapse

Among the main causes of the disease are: constant problems with stool, inflammation of the digestive organs, injuries caused by mechanical objects. Often cracks occur against the background of other diseases. Treatment of fissures that appear in the rectum is mandatory when the first ones are detected anxiety symptoms. IN otherwise the disease becomes chronic.

Doctors call several symptoms of a fissure in the rectum:

Pain localized in the anal area. They can be quite strong and occur not only during bowel movements, but also in other cases, for example, after sitting in one place for a long time.
Bleeding. As a rule, it is small, scarlet in color and does not mix with feces. The appearance is caused by the passage of hard feces through the affected area.
Problems with bowel movements and, as a rule, constipation. The cause is pain. Patients often develop stool sensitivity, which aggravates the course of the disease.

Another symptom of a rectal fissure that occurs in women and men is purulent discharge, which is associated with poor anal hygiene or lack of treatment. If the wound becomes infected, swelling of the anal area may occur. In addition, signs of intoxication of the body develop: heat, weakness, pallor of the skin.

Many patients are interested in how and what to treat a fissure in the rectum if the disease has become chronic. For this you can use homemade candles, compresses, baths. Combination different ways therapy will provide fast decision Problems.

Traditional medicine recipes

To treat rectal fissures and eliminate symptoms, various folk remedies are used:

Fish oil and aloe juice. The ingredients are mixed with the raw chicken egg and using a syringe are inserted into the anus. Fifteen procedures should be performed to heal wounds.
Dandelion root powder – this should be taken orally. Positive effect The remedy is enhanced by yarrow. The herb needs to be brewed and left for thirty minutes. Take the infusion warm.
, motherwort and chamomile. The herbs are mixed with beeswax, which must first be melted, and candles are made, which must be inserted into the anus.

Hygiene plays an important role in the treatment of rectal fissures carried out at home.

The anus needs to be washed warm water after each bowel movement. Oh toilet paper It's better to forget.

Therapeutic baths

Baths have a good effect in the fight against rectal fissures. Suitable for preparing them chamomile infusion or potassium permanganate solution. They have excellent anti-inflammatory properties.

Onions boiled in milk are very useful. The hot broth is poured into a container and covered with a lid with a hole. The patient should sit so that the escaping steam reaches the anus area. Carry out the procedure once a week. No less effective is a bath with the addition of knotweed, hop cones and olive oil. The herbs must be poured with boiling water and simmered on fire for three minutes, then infused. The finished mixture is sent to wide pelvis, then sit down to completely wash the problem areas. Baths are recommended after bowel movements and careful hygiene.

Homemade candles

One of the most common methods of treating chronic rectal fissures and eliminating the symptoms of the disease is cold suppositories, which have hemostatic and analgesic properties. To prepare you will need tansy, birch leaves, chamomile and sage. The mixture is brewed, infused and filtered. The finished infusion must be frozen in the form of candles, and then inserted overnight. The pain subsides after the first procedure.

Potato suppositories are suitable for cases where there is no bleeding or severe pain. They are very easy to prepare: raw potatoes cut out a piece similar to rectal suppository. Candles are inserted into the anus before going to bed, after dipping them in honey. Candles made from corn flour and plantain will cope with even the most advanced cracks. Grind the leaves of fresh grass, squeeze out the juice, add flour to it and knead into a thick dough. Make candles out of it and put them in the freezer.

Compresses

Compresses can also be used to treat a fissure in the rectum. They are placed at night, so they are more effective. Recipes may vary:

Grind ambrosia pigweed, brew it and boil. Cool the broth and soak gauze in it, then apply it to the problem area. In the morning, wash with clean water.
Brew raspberry leaves and leave in a closed container. After half an hour, you can make compresses from the infusion. In addition, the product can be taken orally - it will help normalize the functioning of the rectum and relieve inflammation.
Dissolve propolis in soft butter, apply the mixture to a napkin and apply to the anus.

Diet

When answering the question of how to treat a rectal fissure at home, one cannot help but mention proper nutrition. Fermented milk dishes should be present in the diet - they normalize intestinal function. Dishes containing fiber are also beneficial. It could be prunes wheat bran, boiled carrots and beets. Doctors allow the consumption of boiled meat, broths, and boiled eggs. It is better to avoid sour, smoked and spicy foods forever. A sufficient amount of fluid helps maintain water-salt balance.

If left untreated, an anal fissure can cause dangerous consequences:

bleeding, which increases the risk of anemia;
wound infection with subsequent suppuration and fistula formation;
weakness of the external sphincter;
formation of malignant tumors;
paraproctitis;
violations menstrual cycle among women.

To prevent the development of complications, when the first signs of illness appear, you should contact.

Main part preventive measures measures - following a diet that helps eliminate chronic constipation. In addition, doctors recommend:

increase physical activity;
exercise;
avoid hypothermia;
When working sedentarily, take breaks more often.

If you follow these simple rules, an anal fissure will never bother you. Remember that it is easier to prevent a disease than to treat it later.

Anal fissure is one of the diseases that is not commonly discussed. Indeed, not every person admits that he has problems with anus. And yet, such a disease exists, and millions of people suffer from it. According to statistics, the disease ranks third among proctological diseases after hemorrhoids and paraproctitis. The disease can affect people of any age and gender. Women get sick somewhat more often than men, and children - less often than adults.

Description of the disease

An anal fissure (anal fissure, rectal fissure) is a narrow and long defect in the mucous membrane of the anus. At this point, the mucous membrane seems to be torn into pieces, exposing the muscle layer. The length of the anal fissure is usually small - no more than 2 cm. The width and depth are several millimeters. Cracks may not form anywhere in the anus, but only on its front and back walls. Anterior localization of the crack is much more common in women than in men, which is associated with the biological features of the structure of the weaker sex. Rarely, a crack occurs on the lateral surfaces of the anus.

The disease has two main forms - acute and chronic. A crack that has appeared relatively recently is called acute. A sharp crack may heal if favorable conditions. But without proper treatment, an acute crack can become chronic after a few weeks.

Chronic fissure characterized by rougher edges and small tubercles at its beginning and end. A chronic fissure almost never goes away on its own and requires surgical intervention for treatment. Although the disease may experience remissions, one should not hope that they will lead to a complete cure. Under certain circumstances (diet violation, constipation), the disease may return with renewed vigor. In most cases, an anal fissure is accompanied by sphincter spasm, which makes defecation even more difficult, especially during constipation.

Complications

With each act of defecation, an unhealed fissure is exposed to feces. This is especially dangerous with constipation, when the stool is hard. In addition, it settles on the crack great amount bacteria (as is known, more than half of human feces consists of bacteria). This leads to even greater inflammation of the wound.

Untreated fissures located in the anus can lead to severe complications– acute purulent paraproctitis, fistula formation, trophic ulcers, massive bleeding, gangrene and sepsis. In men, anal fissures increase the likelihood of prostatitis.

Symptoms

Photo: Brian A Jackson/Shutterstock.com

Cracks in the anus make themselves felt severe pain appearing after using the toilet or during the act of defecation itself. The pain is usually acute and resembles the sensation of having a broken glass. Pain syndrome with a crack may persist long time, worsening with prolonged sitting. It can lead to neurotic conditions and insomnia. The patient may also develop a peculiar fear of defecation. This leads to even more severe constipation, which in turn further aggravates the disease.

Also important feature is bleeding during bowel movements. It can be either minor, consisting of a few drops of blood, or serious, leading to anemia. It all depends on the nature and size of the crack.

The disease can affect a person's lifestyle. The inability to sit painlessly entails the inability, for example, to engage in sedentary work. And job loss already exacerbates the unfavorable mental condition sick.

Causes of occurrence

The immediate causes of the disease can be divided into mechanical damage anal passage and damage to the mucous membrane as a result of sphincter tension.

Mechanical damage can occur:

during defecation - due to damage to the mucous membrane hard objects found in feces
during anal sex
at instrumental studies rectal fissure may appear as a result of unqualified actions of medical personnel

Ruptures of the mucous membrane due to muscle tension mainly occur when pushing during bowel movements. Also, quite often, rectal fissures can occur in women during childbirth.

It has long been established that the main factor provoking the appearance of a fissure is chronic constipation. Constant efforts during bowel movements lead to increased tension in the muscles of the anus. In addition, hard feces have Negative influence on the condition of the anal mucosa. All this can lead to its rupture and crack formation. Somewhat less often, cracks can form as a result of diarrhea.

Some experts believe that hemorrhoids also contribute to the formation of anal fissures. Although there is another point of view, which is that hemorrhoids do not affect this process in any way. These two diseases have many similar symptoms, but in general they have different etiologies, and the approaches to their treatment are also very different. However, it is not uncommon to find both diseases present in one patient.

Factors also contributing to the occurrence of the disease are:

drinking alcohol, eating too fatty, spicy or salty foods
sedentary work
lifting weights
sedentary lifestyle
diseases of the lower intestines - colitis, proctitis, irritable bowel syndrome

In addition, diseases of the upper gastrointestinal tract - stomach ulcers and duodenum and gastritis, cholecystitis, blood diseases leading to impaired blood clotting and stagnation in lower parts bodies.

Separately, it is worth mentioning pregnancy and the birth process. These factors can also contribute to the appearance of fissures in the anal area. In the first case, the reason is an increase in the size of the uterus and the associated difficulty in defecation. This weakens the anal area, and childbirth, accompanied by pushing, can cause damage to the anal mucosa. Of course, in the first days after childbirth little attention is paid to this circumstance, but at the moment of the first bowel movement it will inevitably make itself felt.

Anal fissures in children

This disease is more common in adults, but its occurrence in children cannot be excluded. IN in this case it can also be associated with constipation, as well as the fact that in children the excretory organs are not yet fully formed. Therefore, even relatively mild constipation can cause damage to the child's anal area. Symptoms of an anal fissure in young children may include fear of the toilet, blood in the stool.

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Diagnostics

When pain occurs in the anus, the patient is naturally unable to determine the cause of the syndrome and make a diagnosis, and, moreover, determine the size and shape of the crack. Therefore, it is recommended to immediately contact a proctologist so that he can analyze the symptoms and prescribe treatment. In most cases, cracks are clearly visible upon visual inspection. In some cases, palpating the anus may be necessary, but this operation may be difficult due to extreme pain for the patient and spasm of the sphincter. Also used for diagnosis are sigmoidoscopy (examination of the anus 20 cm deep) and colonoscopy. When diagnosing, it is necessary to differentiate a fissure from hemorrhoids, proctitis and paroproctitis, erosions, polyps and tumors.

How to treat the disease

Treating a fissure in the anus, especially one that arose long ago and is large in size, is a difficult task. Nevertheless, complete cure cure for the disease is possible, although it requires significant effort, both on the part of the patient and on the part of doctors.

Unlike many other diseases, with anal fissure acute form illnesses are treated conservative method, and chronic - surgical.

If an anal fissure occurs small size– microcracks, it is better to let it heal on its own. Such cracks can heal in a few days, provided that they do not become re-irritated. This can be achieved if stool does not form and does not come out. That is, you can go on a diet for several days and wait until the crack heals itself.

However, as a rule, the anal fissure is too large and will take too long to heal. In case of large cracks, use complex method treatment, which includes:

drug treatment
diet
lifestyle change

How to treat the disease

Conservative treatment of cracks is carried out using a comprehensive and gradual method. Practice shows that effective treatment diseases can be treated at home. In the presence of severe pain and sphincter spasm, painkillers and antispasmodics are first used, and then wound healing agents are used. In most cases, treatment can be carried out at home and hospitalization is not required. Duration conservative treatment depends on the severity of the disease and the chosen course of therapy and can take from 2 to 8 weeks. Medicines that are used for fissures can be delivered to the anus either directly or taken in the form of tablets.

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Of the tablet medications, laxatives should be noted first. These drugs can be prescribed in case of illness caused by constipation. As a rule, preparations based on senna and aloe are the most effective, but they are contraindicated for irritable bowel syndrome. In this case, it is best to use preparations based on plantain seeds and artificial cellulose. You can also use laxatives based on polyhydric alcohols, such as Duphalac.

Antispasmodic medications, such as drotaverine, can also be taken in tablet form. Antibiotics in tablets for anal fissures are usually not prescribed, since local remedies are much more effective.

Main forms for rectal treatment:

baths with bactericidal solutions
candles (suppositories)
ointments and creams
microenemas

The choice of dosage form is dictated by the circumstances of the disease and associated symptoms. With strong pain syndrome It is difficult to use suppositories, and for discharge from the anus - ointments. In some cases, injections of painkillers and antispasmodics are indicated.

An anal fissure, in its etiology, differs little from an ordinary wound, and when treating it, similar principles must be followed. However, two things should be taken into account unfavorable factors, which make it difficult to treat the crack - concomitant with the disease sphincter spasm and persistent infection of the wound area pathogenic bacteria. Therefore, drugs used in the treatment of cracks must perform two functions - remove muscle spasm and have strong anti-inflammatory and bactericidal properties.

Ointments

Ointments should usually be applied to the area around the anus once or twice a day after bowel movements. There are antispasmodic ointments and ointments with a predominantly wound-healing effect.

Among the locals antispasmodics Nitroglycerin ointment 0.2% has proven itself well. This ointment is not sold in pharmacies in finished form, and is prepared in a pharmacy upon presentation of a doctor's prescription.

Among the new treatment methods, ointments containing botulinum toxin, which relieves vascular spasms, should be noted.

For antiseptic purposes, use ointment for cracks with strong antibiotics, for example, Levomikol containing chloramphenicol. Ointments based on sea buckthorn oil, Relief ointment, and Argosulfan have also proven themselves well. high efficiency showed the drugs Actovegin and Solcoseryl, which stimulate healing processes.

Also worth noting are the ointments Ultraproct, Aurobin, Dexpanthenol, Bepanten, Methyluracil.

Suppositories

Healing suppositories are considered the most effective dosage form for the treatment of cracks. If there are no contraindications for use, then it is preferable to opt for them. Crack suppositories are usually used after bowel movements once or twice a day. Most of them have a wound-healing effect, and many suppositories also have laxative properties. Some drugs may have a stimulating effect local immunity. For example, Posterizan suppositories contain killed bacteria that cause a response from the immune system. This drug also has a wound healing and analgesic effect.

Many suppositories also have an analgesic effect. Among them it is worth noting Proctoglivenol, Ultraproct, Anestezol, suppositories with ichthyol, belladonna extract.

Relief suppositories, containing shark liver components, have both anti-inflammatory, analgesic and hemostatic effects.

Not all suppositories are suitable for use in childhood and during pregnancy. Among the drugs allowed during pregnancy are anti-inflammatory suppositories Natalsid.

You can also note Methyluracil - suppositories that are well suited for wound healing and have immunomodulatory properties, Hepatrombin - suppositories with a hemostatic and healing effect

Baths

At sharp cracks It is recommended every day, preferably in the evening, to take baths with disinfecting solutions, for example, a solution of potassium permanganate. The water temperature should be +40 ºС. Baths with plain warm water can also be performed, which help relieve spasms. The duration of the procedure is 10-20 minutes.

Enemas

For anal fissures, microenemas containing sea buckthorn oil and chamomile decoction help well. This mixture must be injected into the anus in a volume of 50 ml. The procedure is carried out daily before bed for two weeks.

To facilitate stool, you can use counter enemas, administered 10 minutes before. before defecation. They contain 100 ml pasteurized sunflower oil and 200 ml of boiled water.

Diet

The diet is primarily aimed at eliminating the main cause of the disease – constipation. Indeed, no matter how effective treatment with ointments and suppositories is, it will be completely pointless if the next stool leads to severe tension in the sphincter and an even greater increase in the size of the crack in the anus.

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The diet must be selected individually, since different products have different effects in different cases. However, most experts agree that it is best to remove fatty, fried, pickled and sweet foods, smoked foods from the diet and eat more vegetable fiber, contained in vegetables and fruits, fermented milk products. For meat, it is preferable to eat chicken and lean beef. You should also reduce the amount white bread in the diet, replacing it with bran bread and drinking large quantity liquids (except coffee and alcohol).

Lifestyle change

Should be abandoned sedentary image life, show more physical activity to avoid congestion in the lower body. Even simple walks can have a positive effect on the treatment of the disease.

Surgery

If conservative treatment is ineffective, as well as when the disease progresses to chronic stage, which usually occurs a month after the formation of a fissure in the anus, is shown surgical treatment. As a rule, the operation consists of removing scars and bumps along the edges of the crack that interfere with its healing. The operation can be performed as traditional way, and with the help of a laser. If the treatment of the fissure is prevented by sphincter spasm, then a sphincterotomy operation is performed - partial cutting muscle fibers sphincter.

Prevention

Compliance with preventive measures to prevent the disease will be useful not only for those who have already recovered from the disease, but also for those who have never encountered it.

The risk group includes people who lead a sedentary and sedentary lifestyle and suffer from constipation. Prevention of cracks largely coincides with the measures that are used in their treatment. First of all, it is aimed at preventing constipation. It is necessary to be physically active, move more, eat a varied diet, little by little, but as often as possible. Great importance It has chewing thoroughly food because it is solid undigested remains increase the likelihood of injury to the anus. Therefore, it is necessary to treat diseases of teeth and gums in a timely manner. Anal sex should also be avoided.

Initially, a surface crack of a small size, several millimeters in length, may form. Subsequently, it increases and becomes deeper. Its size can be up to 15 mm, especially in children who suffer frequent constipation. Enlargement of the crack leads to reflex contraction muscle tissue, which is accompanied by pain and interferes with its healing.

The resulting rectal fissure has a slit-like shape. It has soft edges and a red bottom, which is muscle tissue.

If the first manifestations are left without due attention and not started timely treatment, the situation will get worse. The crack is getting oval shape, and fibrinous plaque forms along the edges and bottom. Over time, the pathology can become chronic.

Causes

Violation of the rectal mucosa can be caused by various factors. Most often similar manifestation occurs as a result of mechanical damage and inflammatory process stomach. A combination of factors increases the possibility of rectal injury in children.

IN digestive system all organs are interconnected. Inflammation that occurs in one section spreads throughout the entire tract. A characteristic phenomenon occurs in the presence of worms, which cause inflammation and swelling lower section intestines. Worm eggs cause severe itching, in which a child, scratching the anus, inflicts on himself mechanical damage. The condition is complicated by passing feces.

Not fully formed digestive organs in a child they often cause diarrhea or constipation. Liquid masses irritate the inner surface of the rectum and cause swelling. With constipation, the mucous membrane is damaged by hard feces or the passage of a foreign body.

Other causes that can lead to damage to the rectum cannot be ruled out.

These include:

Haemorrhoids;
Laxatives taken a long period;
A perverted form of sexual violence;
Regular consumption of smoked and spicy foods;
Mechanical damage caused by improper execution diagnostic study rectum.

Symptoms

The first sign that a rectal fissure has appeared is the appearance acute pain in this area. Pain may occur unexpectedly and last for a long period. Symptoms worsen with or after bowel movements.

If a rectal problem occurs in a baby, the baby begins to cry a lot during bowel movements. Older children complain of pain after going to the toilet. Some of them specifically try to delay the passage of stool in order to avoid sharp pain. Children refuse to sit on the potty for fear of pain. If you notice changes in your child’s behavior, you should urgently consult a specialist for advice.

In children school age pain in the anus causes tightness. They refuse to pass medical checkup. Parents can convince the child by explaining the seriousness of the disease.

The main symptoms that determine the problem are:

Frequent constipation;
Presence of blood in the stool;
Restless behavior of the child in the toilet;
Feeling of discomfort in the rectal area;
Pain that occurs after going to the toilet.

Diagnostic examination

If signs of a disease are detected, the child should be immediately examined by a specialist. The doctor examines the rectum. When palpating the problem area, the inflamed area is treated with anesthetic agents.

If the child is restless, the mother can visual inspection rectum at home on your own. To do this, you need to carefully spread your buttocks to the sides and examine the anus. If the crack is not visible, parents are not allowed to feel it from the inside. A more thorough examination requires special medical education.

Therapy

An anal fissure in a child usually occurs as a result of trauma to the rectum caused by the dense consistency of feces. Therefore, treatment of children begins with stool restoration. When constipation is eliminated, the damaged area can heal on its own.

To soften stool, the doctor prescribes flax seed or petroleum jelly. Must be observed therapeutic diet and use as prescribed by your doctor local treatment. Usually, the doctor recommends cleansing the stomach with an enema and taking warm sitz baths with the addition of manganese solution or chamomile decoction. To heal the skin in damaged areas, ointments are used that have regenerative properties. Procedures are carried out daily, usually in the evening.

If a child has neurotic constipation, he needs to be shown to a neurologist. After an examination, the specialist may prescribe sedatives. Also, the possibility of disruption of the gastric microflora and the presence of worms cannot be ruled out.

Treatment of rectal fissures in children is carried out with suppositories containing sea buckthorn oil. To administer the drug into the anus, the child must be placed on his side or back. Raising your legs, gain access to the inflamed area, carefully introduce the product into the anus and squeeze the buttocks for three minutes. For babies under one year old, the procedure is carried out twice a day, half a candle, and older children are given a whole one.

An anal fissure causes a lot of pain. For her faster healing apply ointments "Levomekol" or "Flocaine". When carrying out treatment with medications, you must strictly observe the dosage and duration of their use.

Conservative treatment of rectal fissures is carried out, as a rule, without the use of antibiotics. The prescribed course of treatment improves the patient's health condition. It reduces pain and reduces spasms. Timely appeal Seeing a doctor and following the recommendations received allows you to complete the course of therapy without complications.

If drug treatment is ineffective and the signs of pathology do not disappear, surgical intervention becomes necessary. Typically, surgery is performed for chronic forms of anal fissures.

Surgery

If necessary, rectal fissures are removed surgical method. A week after the operation, the wound is healing. To avoid relapses and anal fissures do not recur, muscle fibers are cut during surgery.

After the operation it is necessary to carry out hygiene procedures. They consist of treating the anal passage antiseptics And water treatments after bowel movements. It is imperative to monitor the nature of the stool.

Diet

Treatment various diseases, associated with the functioning of the digestive organs, entirely depends on the diet. Products should cleanse the stomach and help loosen stools. It is recommended to consume fresh fruits and vegetables, fermented milk products, you definitely need to increase your fluid intake.

Treatment at home using traditional methods

Beeswax

The most effective and in an accessible way treatment at home is the use rectal suppositories from natural wax. To prepare them, take 155 grams of wax, add a few grams of crushed dried chamomile, plantain and motherwort flowers.

Mix the wax mixture thoroughly, roll into small cones, and leave in the refrigerator to harden. Use homemade suppositories 3 times a day until all symptoms of the disease disappear.

Herbal ointment

For cooking homemade ointment you need to mix chamomile, St. John's wort and calendula equally.

Take 1 part herbal collection and combine with 3 parts hot olive oil. After cooling, store the ointment in the refrigerator. Use for treatment until complete recovery.

It is important to remember that regardless of whether treatment is carried out with pharmaceutical or folk remedies, it is very important to eat properly.

The foods eaten must have laxative effects. This diet must be strictly followed after surgery throughout the course of treatment and rehabilitation period.