Anal fissures and fistulae are not very common but when they occur, they become a painful and unpleasant condition. Rectal tearing is distressing and highly resistant to treatment and everybody endures it at some point in their life.This tear in the lining of the anus or the skin around it is called anal fissure. Fistulae are the abnormal channels from the anus which open onto the skin surrounding the anus.

Anal fissure and fistula have no specific causes but constipation is commonly associated with them.They are also associated with a number of conditions resulting in an inflammatory digestive tract. These conditions may be Crohn's disease or ulcerative colitis or many more. Fistula is caused by collection of pus called abscess or infection, in one of the glands near anus and it may also result in multiple anal fissures.

The fistula symptoms and complications for anal fissure may be sudden and severe pain in the anus or the surrounding area.

The pain may occur spontaneously or during or shortly after the passage of a hard stool. The pain is recurring and sharp and gets worse with a bowel movement. Due to this, the victims avoid opening the bowels which worsens the constipation and so the fissure takes more time in healing.

This condition is also associated with 'sentinel pile', a haemorrhoid – a small vein from inside the anus lying outside- which may bleed sometimes and leave a blood streak on toilet paper.

Anal fistula is generally associated with painful abscess, which may be dull and throbbing, in or near the anus.The abscess has a pus discharge which may be blood-stained. The fistula formation results in continuous seeping of pus or a thin, watery fluid from the anus, which can also be blood-streaked. Large abscesses may also cause fever. Fistula symptoms may also be loss of appetite, abdominal pain, vomiting, nausea, diarrhea, fever and weight loss.

Anal fissure and fistula need care and treatment.

The care to be taken is firstly having a fiber rich diet with fruits and vegetables which prevents the fissures occurrence and fastens the healing process. Medications are also used if healthy diet is not sufficient, for controlling constipation, with over-the-counter medicines.

Creams or ointments that contain pain-killing local anesthetic agents are very useful at relieving the pain of anal fissures. Relief of the pain reduces the spasm in the muscles of the anus, which often prevents the fissure from healing.

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