Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study

Abstract

Anal fissures (AFs) are lesions located in the lower anal canal. They can be primary (chronic or acute) or secondary to a basic disease. There is high comorbidity of depression and anxiety in patients with chronic AF, with poorer quality of life (QoL) and sexual function. This is a case–control study carried out in the San Juan Hospital (Alicante, Spain). Sixty-seven participants were included in the study, including 35 cases and 32 controls: 36 males and 31 females. This study aims to investigate the association of presenting AFs with sexuality, quality of life, anxiety, depression, and anger. The instruments used were the Spanish validated versions of the validated original selected questionnaires. These instruments were used to assess health-related quality of life, anxiety, anger, depression, and sexual function. Results show higher values in cases than in controls with statistical significance in anxiety state and trait; anxiety and depression; bodily pain, general health, and vitality; and 10 of the 12 anger factors. Higher values in controls than in cases with statistical significance in sexuality and many of the QoL factors were found. Addressing these issues in AF surgical patients would be beneficial for their clinical assessment and intervention.

TikTok and YouTube as sources of information on anal fissure: A comparative analysis

“…Anal fissures are one of the most common proctology diseases, having a high morbidity rate and causing overwhelming pain in patients ( 1 ). People between 30 and 50 years old are considered the vulnerable population to anal fissures, without a significant difference in incidence rates between men and women ( 2 ). The longitudinal defect located at the anoderm between the anal verge and dentate line can cause severe pain during defecation and may persist for several hours ( 3 ).…”

“…Although some debate exists on the exact pathogenesis, dry and hard stools may correlate with the occurrence of anal fissures ( 4 ). An acute anal fissure with a course of < 6 weeks has the possibility of recovering and healing when conservative treatment is used ( 2 , 5 ). Without sufficient attention and timely treatment, an acute anal fissure can become chronic and may need operative treatment ( 6 ).…”

“…Without sufficient attention and timely treatment, an acute anal fissure can become chronic and may need operative treatment ( 6 ). Patients with chronic anal fissures always have a poor quality of life and sexual function ( 2 ). Surgical procedures, such as lateral internal sphincterotomy, incur some risk and can lead to fecal incontinence ( 7 ).…”

l-Arginine is a feasible supplement to heal chronic anal fissure via reducing internal anal sphincter pressure: a randomized clinical trial study

“…Anal fissure disease widely affects the quality of life of patients due to impaired social, work, and personal relationships, which are directly associated with the duration of stricken and severity of symptoms (Navarro-Sánchez et al 2021 ; Griffin et al 2004 ). In addition, patients who succeeded in treating chronic anal fissures reported an improvement in bodily pain, health-perception, vitality, and mental health (Tsunoda et al 2012 ).…”

“…The HADS questionnaire (Navarro-Sánchez et al 2021 ; Zigmond and Snaith 1983 ) is a 14-item self-rating scale used to assess anxiety and depression symptoms in chronic anal fissure patients. The questionnaire has two parts, consisting of seven questions related to anxiety (HADs-A) and seven to depression (HADs-D).…”