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ANORECTAL DISORDERS (ANAL FISSURES (DEFINITION (An anal fissure is a small…

- - - - Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why.
      - Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area.
      - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.
      - Childbirth. Anal fissures are more common in women after they give birth.
      - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.
      - Anal intercourse.
  - - - Passing large or hard stools
      - Constipation and straining during bowel movements
      - Chronic diarrhea
      - Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease
      - Childbirth
  - - - Pain, sometimes severe, during bowel movements
      - Pain after bowel movements that can last up to several hours
      - Bright red blood on the stool or toilet paper after a bowel movement
      - Itching or irritation around the anus
      - A visible crack in the skin around the anus
      - A small lump or skin tag on the skin near the anal fissure
  - - - Pain, sometimes severe, during bowel movements
      - Pain after bowel movements that can last up to several hours
      - Bright red blood on the stool or toilet paper after a bowel movement
      - Itching or irritation around the anus
      - A visible crack in the skin around the anus
      - A small lump or skin tag on the skin near the anal fissure
- - - - Alcoholism
      - Anal intercourse
      - Chronic diarrhea or constipation
      - Diet high in fat and low in fiber (high fiber foods include whole grain foods, fresh fruits, and vegetables)
      - Obesity
      - Jobs that require sitting or standing for long periods
      - Lack of physical activity
      - Loss of pelvic floor muscle tone due to age, pregnancy, childbirth, or surgery
      - Severe heart disease or liver disease
  - - - Straining during bowel movements
      - Sitting for long periods of time on the toilet
      - Chronic diarrhea or constipation
      - Obesity
      - Pregnancy
      - Anal intercourse
      - Low-fiber diet
  - - - Grade I hemorrhoids are treated with conservative medical therapy and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) and spicy or fatty foods
      - Grade II or III hemorrhoids are initially treated with nonsurgical procedures
      - Very symptomatic grade III and grade IV hemorrhoids are best treated with surgical hemorrhoidectomy
      - Treatment of grade IV internal hemorrhoids or any incarcerated or gangrenous tissue requires prompt surgical consultation
- - - - Risk factors for getting an abscess include exposure to dirty environments, exposure to persons with certain types of skin infections, poor hygiene, and poor circulation.
      - Chronic steroid therapy
      - Chemotherapy
      - Diabetes
      - Cancer
      - AIDS
      - Sickle cell disease
      - Peripheral vascular disorders
      - Crohn's disease
      - Ulcerative colitis
      - Severe burns
      - Severe trauma
      - Alcoholism or IV drug abuse
  - - - Staphylococcus aureus and streptococci
      - an infection
        
        a tear (rupture) of the intestine
        
        an injury
        
        surgery to the abdomen
  - - - Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear
      - Sensitivity to hot and cold temperatures
      - Sensitivity to the pressure of chewing or biting
      - Fever
      - Swelling in your face or cheek
      - Tender, swollen lymph nodes under your jaw or in your neck
      - Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief if the abscess ruptures
  - - - Properly collect specimen for Gram stain and aerobic and anaerobic cultures.
      - Administer empiric antibiotic therapy if necessary.
      - Administer analgesia.
      - Hydrate the patient.