Pathogenesis (development of disease)
In the pathogenesis of primary anal fissures, hypertonicity of the sphincter muscle plays a central role. Consequently, all causes that increase sphincter tone (sphincter muscle tone) should be discussed. Classically, this is mainly constipation and hard stool.
A secondary anal fissure is caused by an injury of the anal canal due to various diseases (see below). This is then further irritated by increased resting pressure of the sphincter ani muscle. Due to a relative underperfusion (reduced blood supply), there is additionally delayed wound healing.
Etiology (Causes)
Biographic causes
- Occupations involving sedentary behavior
Behavioral causes
- Nutrition
- Low fiber (low fiber) diet
- Sexual habits (anal intercourse/anal sex).
- Overweight (BMI ≥ 25; obesity).
Disease-related causes
- Diarrhea (diarrhea)
- Intestinal infections, unspecified
- Hypothyroidism (underactive thyroid gland) → constipation
- Infections, bacterial and viral
- Crohn’s disease – chronic inflammatory bowel disease (IBD); it usually progresses in relapses and can affect the entire digestive tract; characteristic is the segmental involvement of the intestinal mucosa (intestinal mucosa), that is, several intestinal segments may be affected, which are separated by healthy sections from each other
- Constipation (constipation)
Injuries, poisonings, and other consequences of external causes (S00-T98).
- Injury to the anal region
Operations
- Anal surgeries
