Anal Fissures

A. An anal fissure is a longitudinal tear in the distal anal canal, usually in the posterior or anterior midline. Anal fissures may be associated with secondary changes such as a sentinel tag, hypertrophied anal papilla, induration of the edge of the fissure, and anal stenosis. A patient with multiple fissures, or whose fissure is not in the midline, is more likely to have Crohn's disease.

B. Anal fissures are caused by spasm of the internal anal sphincter. Risk factors include a low fiber diet and previous anal surgery.

C. Patients with anal fissures complain of perirectal pain which is sharp, searing or burning and is associated with defecation. Bleeding from anal fissures is bright red and not mixed with the stool.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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