What Causes Itching And Pain In The Anus Caused By Anal Fissure?

Posted on Mon, 20 Mar 2017

Question: I have one small round sore on my anus, im hsv 1 positive and am worried its spread. It only hurts when i wipe or am sweaty in the area, and itches some times but not alot and not that i cant ignore, and ive just gotten over having a week long bout of really soft stool from my antibiotics for bv, could it just be a fissure? Or should i be concerned

Answered by Dr. Hari Charan Perigela (1 hour later)

Brief Answer:
It looks like Anal Fissure.

Detailed Answer:
Hi
As per your description, it looks like Fissure in ano.
You should take high fiber diet,drink plenty of liquids.You should eat fresh fruits and vegetables.
If your stool is soft,the fissure heals in course of time.
In addition to dietary modifications, I prescribe Ointment Diltiazem for anal application to my patients with similar complaints.
Nothing to worry.It will be healed.
Hope I answered your query.If you have any questions, I will clarify further.
Wish you good health.
Regards

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Hari Charan Perigela (9 hours later)

today there has been a lot more itching and discomfort, this is only the third day that i have noticed this. the only time that there is any sort of bleeding is when i have wiped myself too much. and upon doing some research i read that there is normally spasms with fissures, which i do not have. the itching sensation i have is almost the feeling of not having been cleaned thoroughly after a bowel movement. i am super paranoid about spreading my hsv 1 to other places and am hoping that its nothing. the lymphodes in my neck are swollen, but im not sure that really indicates anything because i am also battling a vicious cold and cough.
thank you for reading my concerns

Answered by Dr. Hari Charan Perigela (51 minutes later)

Brief Answer:
Spasms are not seen in every patient.

Detailed Answer:
Hi
The main complaints in Anal fissure are Pain,Discomfort while passing the stool .In some,the pain continues even after defecation.
I have seen many cases of Anal fissure without spasms.
Do not rub too much while cleaning. Trauma will aggravate the fissure.
Commonest cause of enlargement of lymph node
is bacterial infection. FNAC (Fine needle aspiration cytology )of the swelling will give a clue.If the lymph nodes doesn't come down after Antibiotic and Anti inflammatory medicine, FNAC has to be done.
Nothing to worry.
Hope I answered your query.
Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Hari Charan Perigela (14 minutes later)

is it normal for there to be no pain while defecating, my last bowel movement was yesterday. today i feel, not constant but close to, discomfort. but because of the itching i have wiped the area and that does hurt. and it really hasnt bled while wiping today either. is the lack of bleeding from the spot, and the consistant pain without defecation worrisome? i do plan on making an appointment with my physician during the week.

Answered by Dr. Hari Charan Perigela (2 minutes later)

Brief Answer:
It doesn't pain daily.

Detailed Answer:
Hi,

Fissure is nothing but a crack in the anal canal.Trauma due to hard stool will increase the pain while causing injury to the sensitive anal mucosa. If the stool is soft,pain will be absent.
Bleeding due to Fissure is also not seen in many patients.

You should consult a General Surgeon or Lower GI surgeon, get examined clinically and proceed further.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Hari Charan Perigela (13 minutes later)

one last question, and thank you again for all your replies. it is much appreciated! the location, isnt right on the anal opening, its a little further from it, are fissures, only in the anus and anal opening?
it still is only one small round sore, there isnt any others. i know that hsv presents itself differently for different people, and im trying hard not to be concerned. will my nurse practioner whom i see for my primary care be able to distinguish between the two if i set up an appointment with him/her

Answered by Dr. Hari Charan Perigela (6 minutes later)

Brief Answer:
Fissure is seen only in the Anal canal.

Detailed Answer:
Hi,

Fissure is seen only in the Anal canal. In long standing cases, skin gets protruded and referred as Haemorrhoides .

If the lesion is away from Anal opening, Fistula in ano has to be excluded. It is communication to the Anal canal/rectum. There will be a small opening near Anus, which discharges Pus/Pinkish material.

There is no medical treatment for Fistula. It has to be operated. The entire fistulous tract has to be removed.

Yes, an experienced Nurse practitioner may diagnose correctly.
If you come back after consultation, I can clarify further.

Wish you good health
Regards

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Above answer was peer-reviewed by : Dr. Arnab Banerjee