81. Berkshire Surgical Associates: Surgeons Specializing In The Treatment Of Colorec anal fissures. What Is an Anal Fissure? Sometimes fissures may deepen to reachthe underlying sphincter muscle (the muscle around the anal canal). http://berkshiresurgical.com/colon_rectal_cancer_education/anal_fissures.htm

Anal Fissures What Is an Anal Fissure? An anal fissure is a split or tear in the lining of the anal canal (rectal opening). When Does a Fissure Occur? What Are the Symptoms? Symptoms of a fissure can include: Anal pain. People often describe it as burning or tearing pain with a bowel movement. The pain may last for minutes or persist for hours after a bowel movement. The pain that lasts after a bowel movement is caused by the spasm in the sphincter muscle. Some people avoid having a bowel movement because of the pain. Rectal bleeding. It is usually small amounts of bright, red blood that can be seen on the toilet paper or in the toilet water. Swelling. Swelling at the outer end of the fissure can result in a skin tag. It may be noticed when cleaning the rectal area. Itching. Discharge may result as the fissure alternately heals and reopens, causing itching. How Is a Fissure Treated?

82. UNC Student Health Service: Virtual Health Library: Gastrointestinal American Society of Colon and Rectal Surgeons Patient Brochure anal fissureshttp//www.fascrs.org/brochures/analfissure.html Appendicitis. http://www.shs.unc.edu/library/gastro.html

SHS Virual Health Library Outside Resources Anal fissures American Society of Colon and Rectal Surgeons: Patient Brochure: Anal Fissures http://www.fascrs.org/brochures/anal-fissure.html Appendicitis National Digestive Diseases Information Clearinghouse: Appendicitis http://www.niddk.nih.gov/health/digest/summary/append/index.htm Canker sores/aphthous ulcers Aetna Intelihealth: Aphthous Stomatitis (Canker Sores or Recurrent Mouth Ulcers) DermStore: Whitening Toothpaste for Canker Sore Sufferers http://www.dermstore.com/byprodid_Whitening+Toothpaste+for+Canker+Sore+Sufferers_448.htm Constipation National Digestive Diseases Information Clearinghouse: Constipation http://www.niddk.nih.gov/health/digest/pubs/const/const.htm Crohn's disease National Digestive Diseases Information Clearinghouse: Crohn's Disease http://www.niddk.nih.gov/health/digest/pubs/crohns/crohns.htm Gallstones National Digestive Diseases Information Clearinghouse: Gallstones http://www.niddk.nih.gov/health/digest/pubs/gallstns/gallstns.htm

83. Site Builder having. Thank you. anal fissures. anal fissures are very common. A fissurecan be thought of as a cut in the anal skin. Because there http://diseasesandtreatments.4t.com/

Free Web site hosting - Freeservers.com Anal Fissure Anal Fissure Colonoscopy Condyloma Acuminatum (Anal and Perineal Warts) Hemorrhoid Treatment ... Reflux Esophagitis (Heartburn) The information provided on this web site cannot substitute for the medical expertise and advice that resides with your primary healthcare provider. We encourage all patients to consult their primary healthcare provider to discuss any health problems they may be having. Thank you. Anal Fissures Anal fissures are very common. A fissure can be thought of as a cut in the anal skin. Because there is no tissue between the skin and the muscle of the internal anal sphincter, a cut in this skin actually exposes the muscle. This is very irritating to the muscle and induces the intense sensation that is felt after a bowel movement. Because there is a break in the skin, bleeding is common. A bowel movement will often reopen the wound causing bleeding and discomfort. The initial treatment is to form a stool that will pass with a minimum of stretching of the anal skin, sometimes allowing the fissure to heal. 0.2% Nitropaste ointment aids this healing. This should be applied with a cotton-tipped applicator in the morning, before bed, after a bowel movement, or if the pain grows severe. This ointment works by relaxing the anal sphincter muscle. The common side effect from Nitropaste is headache that occurs when too large of a skin area absorbs the medication. This is the reason it is applied with a cotton-tipped applicator. Too much medication is absorbed through the fingers if applied directly, often causing a headache. Occasionally, headache occurs despite proper application. You should call and discuss this with the doctor if it occurs to you.

84. Constipation And Hemorrhoids Complications of chronic constipation may include hemorrhoids, anal fissures,and damage to the muscles and supportive tissues of the anus and perineum. http://health.rutgers.edu/brochures/consthem.htm

Constipation and Hemorrhoids General Welcome/Mission Health Centers Services Departments ... Links/Resources After food leaves the stomach, it enters the small intestine, the beginning of the lower gastrointestinal (GI) tract. As it passes through, the major portion of digestion and absorption takes place. Undigested food residue, debris, and some water then pass into the large intestine, or colon, where almost all of the water absorbed, and the solids are compacted as feces. This fecal mass is stored until distention causes a reflex muscle movement that propels the mass into the rectum for defecation and excretion through the anus. Normally, ingested food passes through this system and its waste products are excreted within 35 – 70 hours, resulting in a normal bowel movement 3-12X/week. However, the defecation reflex is rather weak, and easy to ignore. We ignore the reflex for many reasons, including inconvenience or lack of private, clean, or comfortable bathroom facilities. After a few minutes, the reflex goes away, and will not begin again for several hours. During this time, the fecal mass becomes drier and harder, resulting in constipation. Constipation Constipation describes bowel movements that involve excessive straining, difficulty, or discomfort; or that occur less than twice a week. Although occasional constipation is common, chronic or persistent constipation and associated straining at bowel movements can lead to more serious problems. Complications of chronic constipation may include hemorrhoids, anal fissures, and damage to the muscles and supportive tissues of the anus and perineum. The most common cause of constipation is a diet lacking fluid and fiber; in combination with poor bowel habits, such as routinely delaying defecation. Other causes of constipation may include:

85. Are Non-surgical Treatments For Anal Fissure Effective? (CFP/MFC Archive. Issue/ On examination, you might see a split in the skin of the distal analcanal; most anal fissures occur in the posterior midline. Multiple http://www.cfpc.ca/cfp/2000/May/05_01.htm

ISSN 0008-350X Vol 46: 989 - 1232 MAY MAI HOMEPAGE PAGE D'ACCUEIL Search/Recherche Critical Appraisal Évaluation critique Are non-surgical treatments for anal fissure effective? Leah S. Steele, Rick Glazier Research question How do two non-surgical treatments (botulinum toxin [BT] and topical nitroglycerin [NTG] ointment) compare for treatment of chronic anal fissure? Type of article and design Prospective, single-blind randomized trial. Relevance to family physicians Anal fissure is a common problem that causes substantial discomfort in otherwise healthy people. Patients with anal fissure complain of rectal bleeding and pain during and after defecation. On examination, you might see a split in the skin of the distal anal canal; most anal fissures occur in the posterior midline. Multiple fissures or lateral fissures could be associated with other diagnoses, such as inflammatory bowel disease, tuberculosis, human immunodeficiency virus infection, or syphilis. In the acute condition, anal fissures usually resolve with increased dietary fibre and sitz baths. When fissures persist for longer than 6 to 8 weeks, other modes of treatment are usually indicated. Chronic anal fissures are believed to be associated with spasm and hypertonicity of the anal sphincter. While the exact causes of fissure persistence are not clear, some have suggested that sphincter spasms lead to relative ischemia of the anal canal, which complicates fissure healing. The most common treatments for chronic anal fissures are aimed at alleviating sphincter hypertonicity. This has been achieved surgically by lateral internal sphincterotomy, which is effective but can cause feces and flatus incontinence that is sometimes permanent.

86. Hemorrhoids Fistulas. Fissures. anal fissures. What causes an anal fissure? Making a diagnosis.Can anal fissures ever lead to colon cancer? anal fissures vs anal fistulas. http://www.dekalbsurgical.com/hemorrhoids_anal_fistulas.html

Hemorrhoids Fistulas Fissures Anal fissures ... Return of the fissure Hemo rrhoids Hemorrhoids, or piles, is a painful mass of distended (swollen) veins in the lining of the anus and rectum, resulting from the formation of varicose veins around the anus. Internal hemorrhoids occur at the junction of the anus and rectum and are covered with mucous membrane. External hemorrhoids occur just outside the anus and are covered with skin. On occasion an internal hemorrhoid may prolapse, or protrude, to the outside, cutting off the blood supply. A number of treatments are available for internal hemorrhoids. External hemorrhoids may be treated with local care to relieve pain; if they recur or remain symptomatic they may be surgically removed. Hemorrhoids can occur at any age, often without apparent cause. Causes may include constipation, pregnancy, liver disorders, rectal tumors, and the repeated use of laxatives. Hemorrhoids can cause itching and burning and may bleed during a bowel movement. Hemorrhoids do not cause cancer nor do they become cancerous. But any rectal bleeding may be a sign of cancer of the colon or rectum and should be checked by a physician

87. Adult Health Advisor 2001.1: Anal Fissure anal fissures are a fairly common disorder and occur more often in women.How does it occur? What can be done to help prevent anal fissures? http://www.realage.com/connect/healthadvisor/adulthealth/crs/analfiss.htm

McKessonHBOC Clinical Reference Systems: Adult Health Advisor 2001.1 Anal Fissure What is an anal fissure? An anal fissure is a small cut in the skin of the anus. The anus is the opening through which bowel movements pass. Anal fissures are a fairly common disorder and occur more often in women. How does it occur? Anal fissures are usually caused by small tears in the skin of the anus. These tears occur during bowel movements when hard, dry stools are passed. They may also be associated with: straining at bowel movements when you are constipated hemorrhoids stress waiting too long to have a bowel movement (BM) anal surgery inflammation of the rectum. What are the symptoms? Symptoms can include: painful bowel movements spasm in the muscle at the opening of the anus, caused by irritation of the cut during a bowel movement bright red blood when you have a bowel movement, which you see on the BM, in the water, or on the toilet tissue. How is it diagnosed? Although the doctor can usually diagnose an anal fissure by physical exam, a procedure called anoscopy may be used to confirm the diagnosis. This procedure uses an instrument called an anoscope to examine the anus and lower part of the rectum. Your doctor may want to perform additional studies, such as a sigmoidoscopy, if there is any question about the cause of the fissure.

88. DG DISPATCH - ASCRS: Nitroglycerin Ointment Effective For Treating Chronic Anal Title DG DISPATCH ASCRS Nitroglycerin Ointment Effective For Treating Chronicanal fissures URL http//www.pslgroup.com/dg/1D809E.htm Doctor's Guide June http://www.docguide.com/dg.nsf/PrintPrint/EC4DC074BE0652F68525690D006D7672

To print: Select File and then Print from your browser's menu Title: DG DISPATCH - ASCRS: Nitroglycerin Ointment Effective For Treating Chronic Anal Fissures URL: http://www.pslgroup.com/dg/1D809E.htm Doctor's Guide June 29, 2000 By Margaret Pearson Special to DG News BOSTON, MA June 29, 2000 Patients with chronic anal fissures who are treated with topical nitroglycerin have a significant and rapid reduction of pain, researchers report. A large, randomized, double-blind study of 304 patients with chronic anal fissures was conducted to determine an optimal dose of topical nitroglycerin ointment. Researchers, led by Dr. D. Beck, of the Ochsner Clinic, in New Orleans, LA, randomly assigned 304 patients to receive 375 mg of either 0%, 0.1%, 0.2% or 0.4% of the nitroglycerin ointment applied twice or three times daily. The results were presented at the American Society of Colon and Rectal Surgeon's Meeting, in Boston, MA. Their results showed that there was no significant difference in fissure healing in any of the treatment groups. All patients, including those in the placebo patients, had a 50 percent healing rate. Dr. Beck and his associates found a higher than previously reported placebo rate in their study. Patients treated with 0.4% nitroglycerin ointment did report a highly significant decrease in pain in the first week of treatment.

89. HEMORRHOID CARE MEDICAL CLINIC 888-734-2224, Laser Surgery, Non-surgical Treatme causing a fissure. anal fissures also may be secondary to anorectalsurgery, proctitis, tuberculosis, or cancer of the anus. top. http://www.hemorrhoid.net/fissure.htm

Introduction Causes of Anal Fissure Symptoms Diagnosis ... Surgical Treatment Introduction An anal fissure (AY-nul FISH-er) is a tear in the anus causing a painful linear ulcer at the margin of the anus. An anal fissure, also known as fissure-in-ano, may cause itching, pain or bleeding. Fissures can extend upward into the lower rectal mucosa; or extend downward causing a swollen skin tab or tag to develop at the anal verge, also known as a sentinel pile. Fissures with sentinel pile. Anal Fissure as seen through an anoscope. top Causes of Anal Fissure Either extreme constipation or diarrhea , usually combined with nervous tension over a prolonged period of time, may produce anal abrasions, simple slit-like fissures, or acute ulcers at the anal verge. With constipation, this condition is usually caused by the passage of a hard dry stool that tears the anal lining upon deification. With diarrhea, this condition is usually caused by an over use and over-wiping of an inflamed anal canal. Because of an associated anal crypt infection, causing

90. Anal Fissure A person's susceptibility to anal fissures tends to decline with age. Surgicalcorrection Severe anal fissures need to be surgically corrected. http://www.disability.vic.gov.au/dsonline/dsarticles.nsf/pages/Anal_fissure?open

91. Anal Fissure anal fissures can also be a side effect of another condition, such as proctitis (inflammationof the rectum), Crohn's disease, colorectal cancer, syphilis and http://www.lebanonhealth.com/condi/197.htm

Anal Fissure An anal fissure, also called an anal ulcer, is a single shallow crack in the lining of the anus (the lowest region of your intestines, which also opens to the outside). A fissure begins just inside the anal opening and extends 1/4 to 3/4 inch along the anal wall. An anal fissure can be excruciatingly painful. Passing stools irritates it, and the anal sphincter muscles, at the anal opening, may respond by going into spasm. These combined effects cause extreme pain that is made even worse if the stools are either hard or watery. Despite the pain, a fissure is not dangerous and will probably heal with simple treatment. Don't ignore it, however: If a fissure becomes chronic, scar tissue can form and impede bowel movements, and you may need surgery to correct the problem. Symptoms Drops of bright red blood on bowel movement, toilet tissue, or clothing; rarely the bleeding is more profuse. Tearing or burning pain in the anal region during a bowel movement; dull ache may continue for several hours.

92. Self Care Article More than half of anal fissures heal on their own. anal fissures are nota sign of colon cancer and do not lead to colon or rectal cancers. http://www.chw.healthinkonline.com/dohealth/member/SelfCareWellness/vitSelfCare.

93. RECTAL DISORDERS CPMCnet. Disorders of the Digestive System RECTAL DISORDERS. ANAL FISSURE DEFINITIONanal fissures are shallow, thin, often painful ulcers of the anal canal. http://cpmcnet.columbia.edu/texts/guide/hmg22_0009.html

Disorders of the Digestive System RECTAL DISORDERS ANAL FISSURE DEFINITION Anal fissures are shallow, thin, often painful ulcers of the anal canal. CAUSE Anal fissure can result from passage of large, hard stools or may be a secondary result of anal surgery, proctitis, or other diseases. Since the surface of the skin at the anus has been worn away, defecation irritates the fissure and may cause the sphincter muscles to spasm, resulting in intense pain. Fissures are often associated with constipation or inadequately emptied stools, and may also be linked to stress or hemorrhoids. DIAGNOSIS During a physical examination to locate the source of pain, the fissure can usually be seen, although anoscopy, in which a small plastic or metal instrument called an anoscope is inserted into the lower few inches of the rectum, may be used to confirm the findings. Flexible endoscopy is also useful in establishing a diagnosis. TREATMENT Anal fissures are treated with warm baths and topical creams; stool softeners (brans such as psyllium) are added to the diet. Surgery is generally unnecessary but may be recommended in severe cases. After the fissure heals—which may take 2 to 3 weeks—a sigmoidoscopy may be performed to check for other rectal problems. ANORECTAL FISTULA DEFINITION An anorectal fistula is a hollow, fibrous tract (opening) leading from the anal canal or rectum to the skin through which watery pus drains, irritating the skin and causing itching and discomfort.

94. NHS Direct Online Encyclopedia Anal Fissure Introduction Treatment. anal fissures usually heal spontaneously, and this is helped by a highfibrediet to maintain softness in the stools and to avoid constipation. http://www.nhsdirect.org.uk/nhsdoheso/print.asp?sTopic=Analfissure&sPrintAll=tru

95. Prostate Prostate Archives. genital pain and anal fissures. genital pain andanal fissures. Posted Re genital pain and anal fissures. Posted http://askwaltstollmd.com/archives/cancer/52522.html

Prostate Archives genital pain and anal fissures Prostate Archive Main Archives Page Glossary/Index FAQ ... Search this site! Match ANY Match ALL genital pain and anal fissures Posted by Zach on December 19, 2000 at 01:08:23: I'm really scared and would appreciate any help. Thanks. Zachary age: 28 Follow Ups Re: genital pain and anal fissures (Archive in prostatosis.) Walt Stoll Re: genital pain and anal fissures Dave Re: genital pain and anal fissures Neil Re: genital pain and anal fissures Dr.Frank Re: genital pain and anal fissures Vince F Re: genital pain and anal fissures Eugenie Re: genital pain and anal fissures Dave Re: genital pain and anal fissures Posted by Dave on December 19, 2000 at 14:03:24: In Reply to: genital pain and anal fissures posted by Zach on December 19, 2000 at 01:08:23: Follow Ups Re: genital pain and anal fissures Neil Re: genital pain and anal fissures Dr.Frank Re: genital pain and anal fissures Vince F Re: genital pain and anal fissures Eugenie Re: genital pain and anal fissures Dave Re: genital pain and anal fissures Posted by Neil on December 19, 2000 at 14:15:56:

96. Colorectal Surgical Society Of Australasia - Anal Fissure Cause. Most anal fissures arise following trauma (injury) to the anus. However,anal fissures can occur during bouts of diarrhoea, childbirth etc. http://www.cssa.org.au/patientarticle.asp?ArticleNo=17

97. MyPleasure.com Anal Toys Guide To Sex Toys Tips for selecting, using and caring for anal toys The MyPleasure Sex Toy Guide by Tamar Love http://redirect-west.inktomi.com/click?u=http://www.mypleasure.com/education/gui

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