The Link Between HIV and Anal Fissures

Anal fissures are a common problem that affects about a quarter million people every year. While anyone can develop an anal fissure, they tend to be more common among specific groups of people, including people with human immunodeficiency virus (HIV). In fact, it’s estimated that up to a third of those with HIV will develop anal fissures at some point.

Michael H. Tarlowe, MD, is recognized as a leading provider of treatment for anal fissures in patients at his practice in Deerfield Beach, Florida, including patients with HIV. In this post, learn more about the connection between anal fissures and HIV and what treatments can help.

Anal fissures: the basics

Anal fissures are small tears in the tissue that lines the lower part of the rectum. Many fissures form as a result of passing unusually large or hard stools. You can also be more prone to fissure development if your anal sphincter muscles are very tight or if they tend to spasm. 

Most people with anal fissures have symptoms like:

• Bleeding and/or pain during bowel movements
• Pain after bowel movements, sometimes for several hours
• Itching or burning sensations around the anus

Anal fissures can also be visible, appearing like tiny cracks in the skin near the anus. Sometimes, fissures are accompanied by small lumps or fleshy skin tags.

Young children tend to be especially prone to anal fissures, in part because constipation typically is more common in this age group. People who lead sedentary lives and who don’t eat a lot of fiber may also develop fissures more often. 

Anal fissures and HIV

Anal fissures are also more common among people with certain types of STDs, including syphilis, herpes, chlamydia, anal warts, gonorrhea, and HIV. That’s because all these STDs can affect your anal tissue and muscles.

Many people with HIV experience chronic diarrhea, either due to the virus or to the medications they take. Frequent bowel movements and wiping irritate the anal area, increasing the risk of a painful fissure.

HIV also weakens your immune system. Once a fissure forms, it’s harder for your body to heal itself. As a result, healing can take a lot longer, and your risks of chronic fissures and infection increase.

Medications used to treat HIV may affect your bowel activity, leading to diarrhea or constipation which in turn lead to fissures. 

And finally, receptive anal intercourse strains anal tissue that may already be compromised by the factors listed above. If you do have anal intercourse, it’s especially important to practice excellent anal hygiene and care to prevent fissures and infections.

Treating anal fissures

If you do have an anal fissure, Dr. Tarlowe prescribes treatment that can help. Depending on your needs, he may suggest:

• Increasing your fiber intake
• Drinking more fluids
• Taking over-the-counter stool softeners
• Using injections to relax the sphincter muscle

For severe fissures that don’t respond to conservative approaches, he may recommend a procedure called sphincterotomy that helps relax the anal sphincter so it has time to heal.

Anal fissures can be painful. Without treatment, they can also become infected. If you think you have an anal fissure, call 954-210-7127 or book an appointment online with Dr. Tarlowe today.