Anal Fissure

Anal Fissure Surgery in Ahmedabad

Anus is last part of intestine and it is short muscular ring like structure which opens during passage of stool. Fissure is crack or tear in the inner lining (mucosa) of anus.

Frequently Asked Questions

Anal fissure is caused by any damage to inner lining of anus. It usually occurs whenever there is undue stress like hard stool, chronic straining while passing stool or sometime explosive diarrhoea. Occasionally it may occur due to insertion of thermometer, enema and endoscope or ultrasound probe. It can also occur during child birth process or may be symptom of medical condition like Crohn’s disease., Tuberculosis or other infection.

  • Anal Pain while passing the stool which may persist for sometime even after the bowel movement.
  • Bright red blood on the toilet paper or in the toilet.
  • A feeling of itching or irritation around the anus.
  • A visible or palpable crack in the anal skin Constipation

Careful medical history usualy point towards anal fissure diagnosis and gentle inspection of anus can confirm it. Sometimes examination under anesthesia may require to diagnose and treat the condition. In case of rectal bleeding, presence of warning symptoms or suspicion of medical condition; colonoscopy or sigmoidoscopy is indicated.

Acute or new onset fissure usualy heal by medical therapy alone while chronic fissure may require surgical intervention.

Few home remedies that can help:

  • Adding dietary fibres in food with daily consumption around 25-30 gm
  • Avoiding foods that are difficult to digest like; nuts, popcorn etc.
  • Increase liquid intake and fruit juice
  • Seiz bath: sitting in warm water for at least 10- 15 minutes so that anus is soaked with it. It should be encouraged to do this atleast three to fore times daily especialy after passing stool.It relaxes spasm, increases blood flow to local part and cleans local part without causing discomfort.

MEDICAL MANAGEMENT:

Goal of management is to break vicious cycle of spasm of anal sphincter and repeated tearing of skin.

Medicaly drugs that helps are:

  • Laxative: laxative and stool softener will help by avoiding strain so that helping in healing
  • Local Anesthesia with or without Steroid: Topical anesthetic agent applied prior to bowel movement helps in reducing pain assocaited with defecation. Small amount of steroid is combined sometimes to reduce local swelling.
  • Local NTG cream: Nitroglycerine helps in relieving spasm and increase blood flow to local part so that aids inhealing of ulcer. It is usualy prescribed at bedtime daily.
  • CCB: calcium channel blocker acts like NTG and preferred as having fewer side effect profile.
  • Botulinum Toxin: This is newer technique to relieve spasm of anal sphincter by injecting botulinum toxin into anal canal. It is very costly and may have long term side effect.

SURGICAL MANAGEMENT:

In case of resistance or intolerance to medical management, surgical intervention may be needed. In this internal sphincter is cut or streched by finger to relax the anal canal.