Anal fissure natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
The symptoms of anal fissure can develop in infants as well as in adults following episodes of severe and chronic [[constipation]]<nowiki/>and [[diarrhea]]. If left untreated, the unhealed fissures can get complicated to chronic fissures, [[anal abscess]], [[anal fistula]] and [[fecal incontinence]]. The prognosis is generally excellent and 90% spontaneously heal or with dietary and medical measures.
==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


===Natural History===
===Natural History===
*The symptoms of anal fissure can develop in the childhood in children having frequent [[diarrhea]] or severe [[constipation]].
*The symptoms of anal fissure can develop in the childhood in children having frequent [[diarrhea]] or severe [[constipation]].
*If left untreated, [#]% of patients with anal fissure may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
*In adults, severe and chronic [[constipation]] leads to increased straining efforts which ultimately leads to anal fissure.
*If left untreated, they become chronic anal fissure which frequently have an anal tag and unhealed fissures can get complicated to [[anal fistula]] and [[anal abscess]].


===Complications===
===Complications===
*Common complications of anal fissure include:<ref name="pmid7587755">{{cite journal |vauthors=Fleshner PR, Schoetz DJ, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC |title=Anal fissure in Crohn's disease: a plea for aggressive management |journal=Dis. Colon Rectum |volume=38 |issue=11 |pages=1137–43 |year=1995 |pmid=7587755 |doi= |url=}}</ref><ref>'https://online.epocrates.com/u/2952563/Anal+fissure' title=Anal fissure at Epocrates Online</ref>
*Common complications of anal fissure include:<ref name="pmid7587755">{{cite journal |vauthors=Fleshner PR, Schoetz DJ, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC |title=Anal fissure in Crohn's disease: a plea for aggressive management |journal=Dis. Colon Rectum |volume=38 |issue=11 |pages=1137–43 |year=1995 |pmid=7587755 |doi= |url=}}</ref><ref>'https://online.epocrates.com/u/2952563/Anal+fissure' title=Anal fissure at Epocrates Online</ref>
**Failure to heal and become  
**Failure to heal and become chronic fissures
**[[Anal abscess]] or [[Anal fistula|fistula]]
**[[Anal abscess]] or [[Anal fistula|fistula]]
**[[Fecal incontinence]] after surgery
**[[Fecal incontinence]] after surgery
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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{{WikiDoc Sources}}


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[[Category:Medicine]]
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[[Category:Gastroenterology]]
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Latest revision as of 20:24, 29 July 2020

Anal fissure Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

The symptoms of anal fissure can develop in infants as well as in adults following episodes of severe and chronic constipationand diarrhea. If left untreated, the unhealed fissures can get complicated to chronic fissures, anal abscess, anal fistula and fecal incontinence. The prognosis is generally excellent and 90% spontaneously heal or with dietary and medical measures.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of anal fissure can develop in the childhood in children having frequent diarrhea or severe constipation.
  • In adults, severe and chronic constipation leads to increased straining efforts which ultimately leads to anal fissure.
  • If left untreated, they become chronic anal fissure which frequently have an anal tag and unhealed fissures can get complicated to anal fistula and anal abscess.

Complications

Prognosis

  • Prognosis is generally excellent and the patients with acute anal fissure is approximately 90% spontaneously heal or with dietary and medical measures.[3]
  • Fecal incontinence occurs in 56.5% of patients undergoing surgery.

References

  1. Fleshner PR, Schoetz DJ, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC (1995). "Anal fissure in Crohn's disease: a plea for aggressive management". Dis. Colon Rectum. 38 (11): 1137–43. PMID 7587755.
  2. 'https://online.epocrates.com/u/2952563/Anal+fissure' title=Anal fissure at Epocrates Online
  3. Jonas M, Scholefield JH. Anal fissure. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. Available from: https://www.ncbi.nlm.nih.gov/books/NBK6878/

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