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Immediate treatment for anal fissures is essential as it could become a chronic condition. You can avail the best-in-class treatment for anal fissures at Pristyn Care, as we are equipped with cutting-edge laser surgery, anorectal specialists, and medical care coordinators at no-cost EMIs.
Immediate treatment for anal fissures is essential as it could become a chronic ... Read More
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An anal fissure is a tiny yet painful tear in the skin lining the anal canal. Due to the presence of multiple nerve endings in the region, even minor injuries are extremely sensitive. Most of the fissures form in the posterior midline of the anus. The blood flow is slightly lower in this area, which slows down the healing process in some cases.
Acute fissures and chronic fissures are the two main types of anal fissures. Acute anal fissures are fresh tears that usually heal in a few weeks with little care. Chronic fissures, on the other hand, can form a noticeable skin tag or small lump around the tear, called a sentinel pile, if they persist for longer than six weeks. These longer-lasting fissures may also involve muscle spasm in the anal sphincter, further limiting the blood flow and slowing recovery.
• Disease name
Anal Fissure
• Surgery name
Lateral Internal Sphincterotomy
• Duration
15-20 minutes
• Treated by
General Surgeon
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The symptoms of anal fissures are usually difficult to ignore, particularly during or after bowel movements. In addition to the severe pain and discomfort, they can cause other symptoms that could be confused with piles or other rectal issues. Common signs and symptoms include:
This is usually most severe while passing faeces and is sometimes described as a cutting or tearing sensation.
Depending on how severe the tear is, the pain may last for a few minutes or even hours after the bowel movement.
A small amount of bleeding in the stool or toilet paper.
After cleaning or wiping, some people experience irritation around the anus.
A small split in the skin may sometimes be seen using a mirror or during a physical examination.
A skin tag or swollen area, known as a sentinel pile, may sometimes accompany chronic fissures.
Usually, the symptoms develop suddenly and could worsen if the fissure doesn’t heal properly. If the pain and discomfort worsen or do not go away in a few weeks, the chronic fissure requires a proper anal pain treatment.
Passing a dry or bulky stool puts pressure on the anal opening. It stretches the skin beyond its normal limit, causing a tear.
Persistent or recurrent constipation puts strain on the anal muscles. Excessive straining during bowel movements may weaken the tissue over time and make it more prone to tearing. Constipation also reduces the blood flow to the area, delaying the healing process further.
Loose or acidic bowel movements, usually experienced during diarrhoea, may irritate the skin. Additionally, constant wiping may also damage the area and prevent small tears from healing properly.
In some cases, the pressure is placed on the anal area during childbirth, which leads to the development of a fissure. A fissure may develop during labour or a few days or weeks after the delivery.
Minor injuries, such as forceful wiping, irritation, use of rectal thermometers, etc., may cause a tear in the anal area.
In several cases, the internal anal muscles are already tense and may further tighten in response to the pain. This muscle spasm reduces the blood supply to the area and slows down the healing process. The tightness in the area also increases the likelihood of reopening of the tear with every bowel movement.
Fissures that are not healed properly or keep coming back indicate an underlying health condition. Several medical conditions, such as Crohn’s disease, inflammatory bowel disease, or infections such as tuberculosis and HIV, affect the skin around the anus. Elderly individuals and people with vascular issues have slower blood circulation, which delays healing.
The majority of acute anal fissures heal on their own in a few weeks. If they do not heal, it is usually because of the persistent muscular spasms that prevent the wound from getting better. This condition may get more painful with time. Untreated anal fissures might also lead to the following complications:-
It is a condition in which the anal canal narrows.
An untreated wound infection can cause an anal fistula, a tunnel that connects the anus to the external skin.
Persistent constipation can cause faecal matter to become stuck in the rectum and back up into the large intestine. This condition is called faecal impaction.
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Non-Surgical Anal Fissure Treatment
When used topically, nitroglycerin helps in healing by increasing the blood flow to the fissure. It functions by causing the sphincter muscle to relax, which eventually helps the tear heal. This ointment works well to treat anal fissures that cause moderate to severe pain.
The doctors recommend calcium channel blockers, which also relax the blood vessels in the anal muscles, if topical nitroglycerin doesn’t work.
Botox injections are considered the last resort, before considering surgical procedures, if neither of the aforementioned medications is effective. Botox is a muscle relaxant that works for about three months, giving the fissure enough time to heal without the sphincter muscle spasms.
Surgical Anal Fissure Treatment
Internal Sphincterotomy Lateral (Laser/Open)
Surgery becomes the only choice if the anal fissure recurs after a while or does not go away with medicines. This procedure involves making a tiny lateral incision in the internal anal sphincter, which is called a lateral internal sphincterotomy. After locating the muscle with an anoscope, a laser or scalpel is utilised to cut it. The process is carried out while under anaesthesia. Cutting the muscle gives the fissure enough time to heal by releasing excess stress. It is usually done as an outpatient surgery and takes around half an hour to finish.
Stages of Fissure Healing
Stage 1: Acute Fissure
It is the first step of fissure healing. The surrounding tissue may be painful and inflammatory during this time since the tear is still fresh. Bright red blood on the stool or toilet paper, severe pain during bowel movements, and discomfort that may last all day are the usual symptoms at this stage. In order to confirm the diagnosis and begin with the proper treatment, it is essential to seek medical attention at this phase.
Stage 2: Inflammation and Scab Formation
The body begins the healing process as the acute phase progresses. A scab or a tiny clot may form to shield the wound when inflammation surrounding the fissure starts to lessen. As a natural barrier, the scab promotes healing and prevents further damage. People may feel less pain and discomfort at this stage, but to support the healing process, it is important to stick to the recommended treatment regimen.
Stage 3: Granulation Tissue Formation
New tissue starts to form during the granulation tissue production phase, which is the next stage of fissure healing. Granulation tissue, which is made up of connective tissue and microscopic blood vessels, indicates that the body is actively repairing the fissure. Gradually, the scab disappears throughout this phase, enabling the development of healthy tissue. Even while soreness could still exist, it usually goes away as the healing process advances.
Stage 4: Epithelialization and Maturation
Epithelialization and maturation take place during the last phase of fissure healing. A new layer of skin is created as epithelial cells move to cover the wound. Reinjury is less likely as the tissue grows more robust and durable. People may feel little to no pain or discomfort at this point. To avoid recurrence, it is crucial to maintain healthy bowel habits and proper anal hygiene.
Mild cases of acute anal fissure can be treated with the help of several home remedies. The following are a few of the chronic fissure treatment options that you can try at home to alleviate the symptoms.
You can treat anal fissures to some extent with the help of the following:
You can treat acute fissures with ointments that contain nitroglycerin like Rectiv, which helps increase blood flow to the fissure and promote healing. Additionally, you can use topical anesthetics like lidocaine for pain relief.
If you notice an anal fissure, scheduling a doctor’s appointment is crucial as untreated fissures could become a chronic condition. Moreover, recurring anal fissures can point toward a more significant issue.
The treatment for anal fissures depends on their type. For example, medications can treat an acute anal fissure; however, chronic fissures are better treated with surgical intervention like laser fissure surgery.
For the most part, anal fissure surgeries are successful, and the patient is satisfied. However, like any other surgery, there could be potential complications during the surgical process. Some of the complications and contradictions that can occur can include:
To find the best fissure doctor near you, search for specialists with experience in treating anal fissures. Consult with highly trained and experienced anorectal surgeons for a detailed consultation and advanced laser surgery to get rid of your painful anal fissure.
Aurodeep Jena, 26 Yrs
Recommends
Nurses are Very responsive and everything went well.
Porshia Rani
Recommends
Five star rating for doctor.. Doctor ki jitni tarif ki jaye utni km h...friendly nature with patient , because I m lady but i feel very comfortable
Himanshu Jindal
Recommends
Fissure was creating too much pain in my body and in my life too from past couple of months but all the procedure which i have to go through and everything was so easy and seamless doctor, hospital treatment evrything was great.
JASIM, 29 Yrs
Recommends
I was very thankfull to the doctor and hospital staff. Had anal fissure treatment. It was effective and an now i am free from pain, and finally got relief after treatment.
Junaid
Done weightloss surgery, reduced weight 10% in a month. Good!
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