Anal fissures and anal fistulas are two common anorectal conditions that can cause significant discomfort and affect daily quality of life. Although they both occur in the anal region, they are different medical problems with distinct causes, symptoms, and treatment approaches. An anal fissure is typically a small tear in the lining of the anal canal, while an anal fistula is an abnormal tunnel that forms between the anal canal and the skin near the anus.

Despite how common these conditions are, many people hesitate to seek medical care due to embarrassment or uncertainty about their symptoms. However, early evaluation is important, as prompt diagnosis and treatment can help relieve symptoms and prevent complications.

Patients experiencing persistent anal pain, discharge, or bleeding may benefit from consulting a colorectal surgeon Singapore for proper diagnosis and treatment. To learn more about colorectal conditions and available treatment options, you can also read more here https://colonoscopydoctor.sg/anal-fissures/.

What is Anal Fissure?

An anal fissure is a small tear in the thin lining of the anal canal, often caused by trauma to the area during bowel movements. This condition is relatively common and can occur in people of all ages. Although fissures are usually small, they can cause significant discomfort because the anal canal contains many sensitive nerve endings.

The most common symptom of an anal fissure is sharp pain during or after passing stools. Some patients may also notice bright red blood on the toilet paper or in the toilet bowl. In addition, spasms of the anal sphincter muscles may occur, which can worsen pain and slow the healing process.

Anal fissures are often associated with conditions that place strain on the anal canal. Common contributing factors include passing hard or large stools, chronic constipation, frequent straining during bowel movements, or prolonged episodes of diarrhea. In some cases, fissures may also develop after childbirth or due to inflammation in the anal region.

While many acute anal fissures may heal on their own with conservative care, persistent or recurrent symptoms may require further evaluation to determine the most appropriate management approach.

What is Anal Fistula?

An anal fistula is an abnormal tunnel that forms between the anal canal and the skin near the anus, usually as a result of a previous anal abscess. Unlike fissures, fistulas typically do not heal on their own and often require medical intervention to prevent recurrent infection and discomfort.

Common symptoms of an anal fistula include persistent pain or swelling around the anus, discharge of pus or blood from an opening near the anal area, and recurrent anal abscesses. Some patients may also experience irritation or itching of the surrounding skin due to constant drainage.

Anal fistulas develop when an infection in the small anal glands spreads, creating a pathway from the inside of the anal canal to the skin surface. The complexity of the fistula, such as its course relative to the anal sphincter muscles, can vary, which affects both symptoms and treatment options.

How a Colorectal Surgeon Singapore Diagnoses These Conditions

Accurate diagnosis is essential because anal fissures and anal fistulas require different treatment approaches. A colorectal surgeon Singapore uses a combination of medical history, physical examination, and imaging to determine the exact condition and severity.

Medical History

The surgeon will begin by asking detailed questions about your symptoms, including:

• Pain during or after bowel movements
• Bleeding or discharge
• Changes in bowel habits
• Duration and severity of symptoms

This information helps guide the next steps in evaluation and determines whether further investigations are necessary.

Physical Examination

A thorough physical examination of the anal region is performed, which may include:

• Digital rectal examination to feel for abnormalities inside the anal canal
• Anoscopy or proctoscopy to visually inspect the anal lining for fissures or fistula openings

Imaging for Complex Cases

For complex or recurrent anal fistulas, additional imaging may be recommended to map the fistula tract and assess involvement with the sphincter muscles. Common imaging techniques include:

• MRI scans – provide detailed cross-sectional images
• Endoanal ultrasound – helps visualize the fistula tract and surrounding tissue

Treatment Options for Anal Fissures

Treatment for anal fissures depends on whether the fissure is acute (recent) or chronic (lasting more than six weeks). Most acute fissures can improve with conservative, non-surgical measures, while chronic fissures may require procedural intervention.

Common non-surgical treatments include:

• Increasing dietary fibre – helps soften stools and reduce strain during bowel movements
• Drinking plenty of water – prevents dehydration and promotes easier bowel movements
• Stool softeners – reduce trauma to the anal lining during defecation
• Topical medications – creams or ointments that relax the anal sphincter and promote healing
• Warm sitz baths – relieve pain and improve blood flow to the affected area

If conservative measures do not relieve symptoms, procedural treatments may be recommended:

• Botox injections – temporarily relax the anal sphincter to allow healing
• Lateral internal sphincterotomy – a minor surgical procedure to reduce sphincter tension and promote healing

A colorectal surgeon Singapore can help determine the most appropriate treatment based on the patient’s symptoms, medical history, and the chronicity of the fissure.

Treatment Options for Anal Fistulas

Anal fistulas typically require surgical intervention, as they rarely heal on their own. The goal of treatment is to eliminate the fistula while preserving normal anal function and preventing recurrence.

Common surgical approaches include:

• Fistulotomy – opening the fistula tract to allow it to heal from the inside out
• Seton placement – inserting a surgical thread to keep the fistula open for drainage and promote gradual healing
• Advancement flap procedures – covering the internal opening of the fistula with healthy tissue to prevent recurrence
• LIFT procedure (Ligation of Intersphincteric Fistula Tract) – closing the fistula tract while minimizing impact on the sphincter muscles

Consulting a colorectal surgeon in Singapore ensures that the treatment plan is tailored to the patient’s condition, balancing effective healing with the preservation of continence and comfort.

When Should You See a Colorectal Surgeon Singapore?

You should see a colorectal surgeon Singapore if you notice any of the following symptoms:

• Persistent pain around the anus
• Bleeding during or after bowel movements
• Pus or discharge from the anal area
• Swelling or recurring lumps near the anus
• Symptoms that last more than a few weeks

Early consultation is important because it can help prevent complications such as infections, chronic pain, or recurring abscesses.

Conclusion

Anal fissures and anal fistulas are common conditions that can cause discomfort and affect daily life, but they are treatable with proper care. Early evaluation by a colorectal surgeon in Singapore can help relieve symptoms, prevent complications, and guide you toward the most suitable treatment. If you are experiencing persistent anal pain, bleeding, or discharge, you can book a consultation at:

Colonoscopy Doctor – Dr Aaron Poh | Colorectal Surgeon Singapore

3 Mount Elizabeth, #14-06a, Singapore 228510

Phone: +65 8875 0080

Home