Fissure is a crack around the anal region. It typically causes severe pain and bleeding during bowel movements. The reason for fissure is trauma inside the inner lining of the anus. A hard bowel is responsible for fissure but chronic diarrhea can also be the cause. Do not leave it untreated. Delay in diagnosis may lead to an acute fissure becoming a chronic one and become more difficult to treat. If anal fissure is not diagnosed, it may also allow other conditions to go undetected and untreated, such as serious infections or even cancer.
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Diagnosis
Most often a gentle inspection of the anal region is required to see the cut or tear. On the basis of location of the Fissure, its cause can be identified. Colonoscopy, flexible sigmoidoscopy and anoscopy may be recommended for further test.
Procudure
Most often a gentle inspection of the anal region is required to see the cut or tear. On the basis of location of the Fissure, its cause can be identified. Colonoscopy, flexible sigmoidoscopy and anoscopy may be recommended for further test.
The laser is used to perform internal sphincterotomy. In this technique, laser energy radial emitting user probe is inserted into the fistulous tract which destroys fistula epithelium and obliterates the rest of the fistula channel/ tract. This procedure is almost bloodless and the surgeon has good control over the operation site. Additionally, the chronic fibrosed scar is debrided with the laser. This prevents any long term discomfort and enables a quicker recovery. Laser techniques is preferred over the open surgery for Anal Fistula due to following reasons:
Quick recovery
Painless procedure
Resume normal activities within a few days
No diet restrictions
Lower risk of infection
In Our Doctor's Word
"Many a times patients confuse fissure with piles. They keep taking home remedies or OTC medicines without knowing the exact cause. This often delays a proper diagnosis and eventually, the correct treatment. At times I have patients coming with severed conditions and combination of different anorectal diseases including grade 4 piles. This makes treatment difficult and recovery longer. So, as a rule of thumb, I will suggest do not trust home remedies/ OTC treatment for permanent cure of piles. If you experience continuous pain, bleeding and abscess, consult a good proctologist as soon as possible and let your doctor decide the best course of action."
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Your safety is taken care of by thermal screening, social distancing, sanitized clinics and hospital rooms, sterilized surgical equipment and mandatory PPE kits during surgery.
A dedicated Care Coordinator assists you throughout the surgery journey from insurance paperwork, to free commute from home to hospital & back and admission-discharge process at the hospital.
Our surgeons spend a lot of time with you to diagnose your condition. You are assisted in all pre-surgery medical diagnostics. We offer advanced laser and laparoscopic surgical treatment. Our procedures are USFDA approved.
We offer free follow-up consultations and instructions including dietary tips as well as exercises to every patient to ensure they have a smooth recovery to their daily routines.
In Kozhikode, one can undergo fissure surgery at a price range between Rs. 37,000 to Rs. 45,000. The price changes from one person to another due to multiple factors like doctor fee, medication cost, charges of diagnostic fee, anesthesia cost, etc.
Bleeding from the anal canal is caused due to a hard stool. The same leads to a lot of pain during and after a bowel movement. There is a chance of opening the anal fissure during a bowel, so it continues to cause discomfort and bleed afterward.
A patient of anal fissure feels unbearable pain caused by spasm of the sphincter muscle in the anus. If the torn muscles catch an infection than it will lead to severe pain.
Without treatment, an anal fissure may lead to reduced blood flow to the site of the injury. Therefore, an increase in anal sphincter muscle pressure, to ultimately impaired healing of the wound. Another big risk is a misdiagnosis, it may lead to conditions such as serious infections or even cancer & remain undetected.
Probably not. In fact, cancer is a relatively uncommon cause for rectal bleeding. The common reason includes anal fissure, anorectal fistula, colitis, and non-cancerous (benign) polyps, etc.
Are fissures and hemorrhoids the same?
Some clinical studies say that 10% of people who underwent laser fissure surgery have developed anal fissure [recurrence of anal fissures] after 6-8 months. So, it is important to follow all the post-surgical tips suggested by the doctor to avoid recurrence.
Anorectal surgeons and proctologists who are experts in performing laser anal fissure surgery may take 15 to 45 minutes to complete it. But the duration of the laser surgery is subject to vary from one person to another due to the severity of the fissure and the presence of any underlying disease that can affect the surgical outcomes.
Once you undergo anal fissure surgery, you may take 1-3 days to resume your daily activities. However, to recover and heal completely without any complications, you may take 3-4 months. If you wish to recover quickly, you should follow all the precautions as directed by the doctor.
Yes, to an extent. Topical calcium channel blockers are considered to be effective ointments for the treatment of anal fissure. These are recommended when other common ointments fail to provide relief from the symptoms. Using these creams for anal fissure for at least 6 weeks can help you get relief from the itching and burning sensations. But, if the fissure has grown very severe, you may need medical intervention.
Like any other small tears and cuts on the skin, anal fissure may heal within a few weeks. But if your condition of anal fissure has grown severe, you may need to check with a general physician who can help you get the best treatments for your anal fissure.
Normally, the cracks and tears don’t cause pus discharge. But if the fissure site contacts infection, it can lead to pus discharge. Once the fissure gets infected, the condition can become chronic and quite painful. If not treated in time, the fissure can grow deeper and form a channel outside the skin.
Here are a few simple tips that can help you relieve fissure itching:
Don’t scratch the fissure area. Scratching may irritate the skin. To find relief from the condition, you can apply compression to the area or take an oatmeal bath. You may want to scratch the area while in your sleep, so you should trim your nails to prevent hurting your area. Wear breathable cotton underwear. Wearing cotton undergarments will help you keep your area dry. Avoid wearing pantyhose and tight fit inner garments because it may trap moisture and irritate the skin.
Clean your anal area gently – Use clean lukewarm plain water to your clean your anus. Use non-irritating mild soap. Do not scrub the area near your anal fissure. Make sure to clean the area with moist cotton balls or plain water if you have diarrhea or incontinence.
Avoid irritants – Do not use anything like perfumed soaps, bubble baths, genital deodorant, or harsh wipes in and around your anal fissure. If you need to clean your fissure area, use unscented toilet paper.
Watch your diet – Cut down on your intake of coffee, cola, spicy foods, citrus fruits, tomatoes or any food that may cause diarrhea. Don’t indulge in laxative overuse
Use gels and ointments – You can use zinc oxide gels or ointments, vaseline petroleum jelly or hydrocortisone cream to find quick relief from the itching and irritating symptoms.
Maintain firm bowel movements – Adding a lot of fiber to your regular diet can help you pass soft and timely bowel movements. For smooth bowel movements, you can also take help of fiber supplements such as psyllium (Metamucil) and methylcellulose (Citrucel).
Anal fissure and anal fistula are two very common anorectal diseases. An anal fissure is a condition where an tear or a crack appears in the skin near the anus. On the other hand, anal fistulas are tube-like passages that appears in the anal canal or the inner rectum. Most anal fissures are like paper cuts and usually get healed within a few weeks. If left untreated, both anal fissure and anal fistula can develop into worse conditions. Untreated fistulas can even branch off into multiple openings.
The symptoms exhibited by both the conditions are very similar to each other. Pain in the anal area, discomfort while sitting at the toilet seat and pain while passing a bowel movement, and blood in stools are some of the common symptoms for both anal fissure and anal fistula. But anal fistulas may also include pus secretion from the anal area, an extra opening near the anus or an increase in diarrhea.
Although different in nature, both the conditions require medical intervention. An anal fissure or anal fistula can be treated by a proctologist or an anorectal/ colorectal surgeon. At initial stages, both the diseases can be managed with medicines. But to treat the condition permanently, one would require a surgical approach, which can be done either through open surgery or laser surgery.
H Jagadeesh
Treatment: Anal Fissure
H Jagadeesh recommended our service
The Doctor explained in detail the problem that I have. Also gave a detailed explanation of remedial measures.