Anal fissure natural history, complications and prognosis

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

Overview

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
- 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.

↑ Fleshner PR, Schoetz DJ, Roberts PL, Murray JJ, Coller JA, Veidenheimer MC (1995). "Anal fissure in Crohn's disease: a plea for aggressive management". Dis. Colon Rectum. 38 (11): 1137–43. PMID 7587755.
↑ 'https://online.epocrates.com/u/2952563/Anal+fissure' title=Anal fissure at Epocrates Online
↑ Jonas M, Scholefield JH. Anal fissure. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. Available from: https://www.ncbi.nlm.nih.gov/books/NBK6878/