Which doctor treats an anal fissure?
If you have an anal fissure, the first point of contact for patients is usually the general practitioner. However, general practitioners will then refer those affected to a proctologist, gastroenterologist, or even a specialized colorectal center. A proctologist is basically a specialist for the rectum and thus also for complaints in the anal region such as anal fissures. Your doctor can also advise you well on how to speed up the healing of the anal fissure.
When to see a doctor for an anal fissure?
If you have acute pain in the anal area and thus suspect an anal fissure, a prompt visit to the doctor is definitely recommended. In many cases, patients wait quite a long time because such complaints in the anal area are often very embarrassing and therefore a doctor’s visit is often delayed with an anal fissure. However, this only leads to unnecessary suffering and worsening of the symptoms of anal fissures, because the earlier you consult the general practitioner or specialist, the sooner an effective therapy and conservative treatment of an anal fissure can be initiated. Find out more here about the causes of an anal fissure. Also be aware that an anal fissure is a wound in an area with a high bacterial load. Therefore, there is an increased risk of infection with an anal fissure, which can lead to secondary diseases such as an anal abscess or even an anal fistula. Read more here about the prevention of anal fissures in the blog post Preventing Anal Fissures.
If you have acute pain in the anal area and blood in the stool, a prompt visit to the doctor is definitely recommended. In many cases, patients wait too long with an anal fissure. An early visit to the doctor can prevent complications and facilitate rapid therapy and treatment of an anal fissure.
How is the diagnosis of an anal fissure made by the doctor?
The diagnosis of an anal fissure begins with a thorough discussion of your medical history, the anamnesis. The doctor will ask you about your symptoms of the anal fissure, such as pain in the anus and blood in the stool or during bowel movements, as well as anal itching. The timing of the symptoms of the anal fissure, their intensity, and whether they are continuously present or improve intermittently are important information to determine whether it is an acute or chronic anal fissure. Furthermore, the doctor will inquire about known diseases, your lifestyle, diet, physical activity, anal intercourse, consumption of cigarettes and alcohol, as well as previous surgeries or diseases in the anal area. Your doctor can also advise you well on how to speed up the healing of the anal fissure.
How is the examination of an anal fissure conducted by the doctor?
There are several examinations and tests that are performed when an anal fissure is suspected to make a diagnosis and to assess the anal fissure more precisely. Usually, a proctological examination is first performed, during which the anal region is visually inspected and the anal canal is palpated to detect any changes. The anamnesis plays a central role here, as a long duration of the symptoms of the fissure over several weeks is a first indication of chronic anal fissures. In cases of chronic anal fissures, the doctor may under certain circumstances recommend an anal fissure surgery as a last treatment option. Learn more here about the duration, sick leave, and surgical techniques of an anal fissure surgery. Your doctor can also provide good advice as a point of contact on how to speed up the healing time of the anal fissure.
Medical examinations for anal fissure
Primarily, the diagnosis of an anal fissure is based on anamnesis and the examination of the external anal canal by the doctor. The anal fissure is often already clearly visible because the tear runs longitudinally toward the coccyx. If the diagnosis is not unequivocally possible or other diseases need to be excluded, a more detailed palpation and inspection are necessary. The doctor or specialist will palpate the anal canal with a finger. Since this examination is very painful due to the tear in the mucosa, the anal region can be locally anesthetized beforehand.
Proctoscopy for anal fissure
For a more detailed examination of an anal fissure, a proctoscopy (endoscopic examination of the rectum) may also be necessary. However, this is usually not indicated during the acute phase of an anal fissure unless the symptoms of the anal fissure are atypical. If conservative therapy or treatment of an anal fissure does not work or if a chronic form of the anal fissure is present, a corresponding proctoscopy makes sense because it provides a good image of the extent of tissue changes.
Find out more here about the various causes of an anal fissure.
