Broadly speaking, a fissure is any sort of tear or division that pulls two parts of something in opposite directions. They can happen in the ground, as is common after earthquakes or other natural disasters, or can happen in buildings, usually as a result of foundation problems or construction flaws. The term is perhaps most commonly used in the medical field, though. In these settings it describes a tear or separation in some sort of bodily tissue. Fissures can happen naturally, which is to say that they occur on their own without environmental triggers; they can also happen as a result of some unusual pressure, accident, or injury. Some of the most common places for these clefts to form are the lungs, the spine, and the anus. Anal fissures are actually quite common, and are usually some of the easiest to treat. Most tears will heal themselves over time, but medication and even surgery is sometimes required depending on the extent of the problem.
Tears that Develop Naturally
Clefts or holes in the body sometimes happen all on their own, usually as a result of some flaw in a person’s growth or development. Divisions during bone growth are a good example, and the spine is a common point of focus. In these cases, the spinal column grows with gaps and bends. It isn’t always problematic and people can often adapt, but in extreme cases it can cause nerve damage, problems with nerve pathways, and issues with uprightness and walking. When caught early on, the problem can sometimes be corrected with surgery, but not always.
Lung divisions are also somewhat common. These also tend to happen naturally and are known as a “normal variant,” though they can profoundly impact things like lung capacity and overall respiratory health. In these situations, one or both lungs basically forms a pocket or pouch. Sometimes this is visible on an X-ray or chest scan, but a lot of this depends on location and severity. In many cases the lungs might actually look normal at first glance, even though they’re divided at the surface level.
Abnormal Examples
Abnormal tears happen in response to something outside the body, like an accident or injury. The most common abnormal type occurs in the anus. This kind of tear may develop when an individual strains the sphincter muscles of the anus when trying to pass out large or hard stools during bowel movements. It is also common in babies between eight months and two years of age after constipation. New mothers who gave birth by vaginal delivery are also susceptible to this condition.
This tear is associated with pain in the anal opening during bowel movements, and it’s often really uncomfortable. In some cases the tear can be severe and chronic. Common symptoms are a tear in the skin around the anal opening, irritation around the anal opening, and pain during bowel movements or when wearing tight clothing. Sufferers may also see blood on the toilet paper or drops of blood in the toilet when passing stool.
Diagnostic Basics
It isn’t always easy to identify a tear or hole based only on simple symptoms since many conditions overlap in this respect. Medical experts usually rely on a combination of medical scans, physical exams, and patient reports in making a diagnosis. Treatment plans often depend at least in part of what’s causing the problem and if it’s something that can be reversed, which makes finding the root of the issue really important.
Common Treatments
In many cases, the best course of action is simply to wait, rest, and see. Most problems will heal on their own given the right circumstance. This is particularly true of issues that are the result of injury or one-time trauma; the body is often able to adapt really well, and people with these issues are often able to lead very healthy, normal lives.
Fissures that are actively causing pain might require some sort of medication or more aggressive treatment, though. An acute anal fissure can often be treated by the use of suppositories or the application of topical creams like rectal corticosteroid, for example, and severe cases may be treated with an injection of botulinum A toxin into the anal sphincter muscles or with surgery. This surgery is called an anal sphincterotomy, and is usually only recommended when the botulinum injections or other medications don't heal the tear. In surgery, a blade is used to make a cut in the anal sphincter muscles to stop pain, reduce spasm, and encourage healing.
Surgery is sometimes also recommended to repair problems. While the body is often able to heal itself, medical experts usually want the body to heal in such a way that a hole or tear gets closed. If it looks like a person is healing in a way that means that the problem is exacerbated, surgery is often recommended to help get things back the way they should be.
Prevention
Prevention is also part of most care plans. Problems with the anus in particular are usually pretty easy to avoid. People are often advised to eat fiber-rich foods and drink plenty of fluids after every meal to improve digestion and reduce the chance of stool strain. Getting exercise and finding ways to reduce stress can also help.