Anal fissure natural history, complications and prognosis

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

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.

• 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.

• Common complications of anal fissure include:^[1][2]
  • Failure to heal and become chronic fissures
  • Anal abscess or fistula
  • Fecal incontinence after surgery

• 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.

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