ananl fissure for under graduate medical.pptx

Anal fissure

1. Anal fissure

2. An anal fissure is a small tear in the lining of the anus. Common in neonates due to delicate mucosa. Incidence Occurs in approximately 1–2% of neonates. More frequent in constipated or formula-fed infants.

3. Causes and Risk Factors Mechanical trauma: Hard stools or forceful wiping. Constipation: Common in formula-fed infants. Diarrhea: Frequent loose stools irritate the area. Perianal infections: Can weaken tissue. Nutritional factors: Insufficient fluid or fiber intake.

4. SYMPTOMS Rectal bleeding: Bright red blood on stool or diaper. Crying during defecation due to pain. Visible fissure: Small tear near the anus. Irritability and discomfort after passing stool

5. DIAGNOSIS Clinical examination: Inspection of the perianal area. History: Check for constipation or straining. Differential diagnosis: Rule out diaper rash or infections.

6. Mangement Conservative Management (First-line): - Dietary adjustments: Increase fluids and fiber. - Topical treatments: Petroleum jelly or zinc oxide. - Warm baths (sitz baths) to relax the sphincter. Medical Management: - Topical anesthetics (e.g., lidocaine) for pain relief. - Stool softeners (e.g., lactulose) to ease defecation. Surgical Management (Rare): Only for chronic cases.

7. Prevention Encourage breastfeeding if possible. Avoid constipation with proper hydration. Use gentle cleaning methods during diaper changes.