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Anal Fissure Treatment - Laser Surgery Procedure & Operation Benefits

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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  • What is Anal Fissure?

    An anal fissure is a small tear in the lining of the anal canal. It can cause discomfort, pain, and bleeding during bowel movements. 

    There are two types of anal fissures: acute anal fissure and chronic anal fissure. 

    Acute Anal fissures are typically caused by trauma to the anal canal, such as passing a large bowel movement. It can be treated with some ointments, medications and home remedies within a few weeks.

    Chronic Anal fissures are tears that persist for more than six weeks. They are often associated with underlying conditions such as inflammatory bowel disease or sexually transmitted infections. Chronic fissures are better treated with surgery. 

    Treatment options for anal fissures include dietary changes, topical medications, and surgery i.e. lateral internal sphincterotomy (LIS) in severe cases.

    • Disease name

    Anal Fissure

    • Surgery name

    Lateral Internal Sphincterotomy

    • Duration

    15-20 minutes

    • Treated by

    General Surgeon

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    How is Anal Fissure Diagnosed?

    To diagnose an anal fissure, your doctor will typically begin by asking you about your symptoms and medical history. They may also perform a physical examination to check for any visible signs of a fissure, such as a small tear or crack in the skin around the anus.

    In some cases, your doctor may need to perform a more detailed examination, such as an anoscopy, to get a closer look at the affected area. 

    During an anoscopy, a small, flexible tube with a camera on the end is inserted into the rectum to allow the doctor to examine the anus and rectum in more detail. This is an outpatient procedure and is performed in the doctor’s clinic.

    In some cases, the doctor may also recommend additional tests, such as a stool sample or blood tests, to check other possible causes of your symptoms. Once the diagnosis of the anal fissure has been confirmed, the doctor may suggest the best suitable treatment plan, which may include medications, lifestyle changes, or in severe cases, surgery.

    Are you going through any of these symptoms?

    What are the Treatment Options for Anal Fissure?

    Treatment options for anal fissures vary depending on the severity of the fissure. There are two types of treatment methods for anal fissures, surgical or non-surgical. 

    Non-surgical approaches include dietary changes, such as increasing fiber intake and drinking more fluids to soften stools and reduce the need to strain during bowel movements. Topical medications, such as nitroglycerin ointment, can also help relax the anal sphincter and promote healing. 

    In more severe cases, surgery may be necessary. Procedures such as lateral internal sphincterotomy or fissurectomy can help to relieve symptoms by reducing pressure on the anal sphincter and promoting healing. It is important to consult with a healthcare provider to determine the best treatment approach for individual cases.

    What are the Different Surgical Treatments for Anal Fissure?

    There are two surgical approaches for anal fissure surgery. 

    Open Surgery

    Open surgery for anal fissures is the traditional method to treat fissures. The following steps are involved in open surgery for anal fissure.

    1. You will be sedated under general anesthesia to ensure that you do not experience any pain or discomfort during the procedure.
    2. You will be positioned in a way that allows the surgeon to access the affected area easily.
    3. The surgeon will make an incision in the skin around the anus to gain access to the anal fissure.
    4. The surgeon will then analyzes the anal fissure to determine the extent of the damage and to identify any other issues that may be present.
    5. Then the surgeon will remove any damaged tissue around the anal fissure to allow for proper healing.
    6. In last, the surgeon sutures the area to close the incision made during the procedure.
    7. Then you will be monitored closely after the procedure to ensure that there are no complications and to manage any pain or discomfort that they may experience.

    Laser Surgery

    Laser-assisted surgery is the most effective treatment for chronic fissures. 

    The following steps are carried out during the procedure:

    1. You will lie on your back with your hips and knees bent and your legs apart. 
    2. The anesthesiologist will sedate you to numb the area or put them to sleep so that you won’t feel any pain or discomfort during the procedure. 
    3. Once you are stable, the surgeon will put a laser through the anus, which is a natural opening in the body.
    4. The surgeon will then move the laser to the spot where the fissure (a small tear) is located.
    5. Using the laser, the surgeon will make a cut in the muscles around the anus. This helps to relax the sphincter muscles.
    6. After the surgery, you will be taken to a recovery room to rest and recover.

    Laser anal fissure surgery is usually suggested for individuals in which conservative measures, such as dietary changes, stool softeners, and topical medications, have stopped working. 

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    What are the Benefits of Laser Anal Fissure Surgery?

    Here are some benefits of laser anal fissure surgery – 

    • Minimally invasive: Laser anal fissure surgery is a minimally invasive procedure that results in less pain and discomfort compared to traditional surgery.
    • Outpatient procedure: The procedure is performed on an outpatient basis, allowing patients to return home the same day.
    • Fewer complications: Anal fissure laser surgery has a lower risk of complications such as bleeding and infection compared to traditional surgery.
    • Short recovery period: The recovery time for anal fissure laser surgery is typically shorter, with patients able to resume normal activities faster.
    • Most Effective: Fissure laser surgery is the most effective option for chronic anal fissure treatment that has not responded to other conservative methods.
    • High success rate: Fissure laser surgery offers a higher success rate than traditional surgery in preventing fissure recurrence.
    • Less pain: The laser seals the nerve endings, resulting in less post-operative pain and discomfort.
    • Low risk of anesthesia: The procedure can be performed under local anesthesia, reducing the risks associated with general anesthesia.
    • Less scarring: Fissure laser surgery results in minimal scarring, with the incision made by the laser being smaller and more precise.
    • Fewer side effects: The procedure is safe, with minimal side effects and a low risk of complications.

    How to Prepare Before Anal Fissure Surgery?

    While preparing for surgery, it is important to be well-informed about the procedure, what to expect, and self-care tips to help you recover safely after the surgery. 

    Some common preparation tips are as follows:

    • Follow your surgeon’s instructions carefully: Before the surgery, your surgeon will provide you with a set of instructions. Make sure you follow them carefully to ensure a smooth surgery and avoid complications during the procedure.
    • Stop smoking: Smoking can slow down the healing process and increase the risk of complications. If you smoke, stop at least two weeks before the surgery. It is high time to quit smoking as it is always harmful to health. 
    • Avoid blood-thinning medications: Medications such as aspirin, ibuprofen, and warfarin can increase bleeding during and after the surgery. Your surgeon will advise you on which medications to stop taking before the surgery.
    • Stay hydrated: Drinking plenty of water can help keep your bowels moving and prevent constipation before the surgery.
    • Eat a balanced diet: Eating a balanced diet that is rich in fiber can help prevent constipation and avoid complications during the procedure.
    • Prepare your home: Before the surgery, make sure your home is clean and comfortable. Arrange all the stuff beforehand that you may need during your recovery period.

    How to Recover After Anal Fissure Surgery?

    The recovery period may vary depending on the type of treatment, surgical or non-surgical. Usually, non-surgical treatment approaches may take a much longer time to cure fissures as compared to anal fissure laser surgery. 

    Medications

    It takes between 4 to 8 weeks for anal fissures to heal with medication. However, the recovery period may be even longer based on individual factors such as age, general health, and the severity of the fissure. Also, it is important to note that medication alone may not be sufficient for complete healing. It is recommended to consult a proctologist for proper diagnosis and the best treatment option. 

    Home remedies

    There is no fixed timeline for healing anal fissures with home remedies, the process can take anywhere from a few days to a few weeks, depending on the severity of the fissure and the effectiveness of the remedies used. However, it is important to note that home remedies may not work for everyone, and if the symptoms persist or worsen, it is advisable to seek medical attention.

    Open Surgery 

    Recovery time after open surgery typically takes around 4 to 6 weeks, during which you may experience some discomfort and pain. To speed up the healing process, it’s important to follow your doctor’s post-operative instructions and take rest.

    Laser Surgery

    You may take up to 1-2 weeks to recover completely after the laser anal fissure surgery, lateral internal sphincterotomy. But you can return to your normal routine within a week after the anal fissure laser surgery for anal fissures. It is the best and most effective procedure to treat anal fissures within a short period of time. 

    Here are some general tips to help you recover safely after anal fissure surgery. 

    • Take pain medication as prescribed by your doctor.
    • Avoid strenuous activities for up to 1 week after the procedure.
    • Keep the surgical area clean and dry to prevent infection.
    • Avoid strenuous activity or heavy lifting for at least a week after surgery.
    • Eat a high-fiber diet to prevent constipation and strain during bowel movements.
    • Drink plenty of water to stay hydrated and soften stools.
    • Use a sitz bath to soothe the surgical area and promote healing.
    • Avoid sitting for long periods of time, especially on hard surfaces.
    • Follow your doctor’s instructions for wound care and follow-up appointments

    What are the Risks and Complications Associated with Anal Fissure Surgery?

    Like any surgery, anal fissure surgery is also associated with some risks and complications, including;

    • Infection: Any surgical procedure carries the risk of infection. Proper hygiene and post-operative care can help minimize this risk. 
    • Bleeding: Bleeding is a common complication of anal fissure surgery. The risk of bleeding can be reduced by avoiding blood-thinning medications before the surgery.
    • Pain: Pain is a common side effect of anal fissure surgery. Take your over-the-counter medications to alleviate the pain and discomfort.
    • Incontinence: In rare cases, anal fissure surgery can result in incontinence, or the inability to control bowel movements.
    • Anal Stenosis: Anal fissure surgery can result in anal stenosis in rare cases, a narrowing of the anus that can make bowel movements difficult or painful. 
    • Abscess: In rare cases, anal fissure surgery can result in an abscess, which may require further treatment.
    • Allergic Reactions: Some patients may experience an allergic reaction to anesthesia or other medications used during the surgery.
    • Nerve Damage: In rare cases, anal fissure surgery can result in anal nerve damage, which may cause numbness or tingling in the anal area.
    • Recurrence: Anal fissure surgery can successfully treat the condition, but there are chances that fissures may recur. Repeat surgery may be necessary.

    What Lifestyle Changes to Make After Anal Fissure Treatment Through Surgery?

    There are several lifestyle changes help relieve discomfort and promote safe recovery, as well as minimize the chances of recurrence after anal fissure surgery. 

    • Maintain a high-fiber diet to avoid constipation and straining during bowel movements.
    • Drink plenty of water to keep the stool soft and prevent further injury to the anal area.
    • Avoid sitting for prolonged periods, as it can increase pressure on the rectal area.
    • Take regular breaks and walk around to improve blood circulation in the rectal area.
    • Avoid heavy lifting or strenuous exercise for at least 4-6 weeks after surgery.
    • Use sitz baths or warm compresses to reduce pain and swelling in the anal area.
    • Keep the anal area clean and dry to prevent infection and promote healing.
    • Avoid spicy and acidic foods that irritate the anal area and cause discomfort.
    • Take pain medication as prescribed by your doctor to manage post-surgical discomfort.
    • Attend follow-up appointments with your doctor to monitor healing progress and address any concerns.

    What is the Cost of Anal Fissure Surgery?

    The cost of anal fissure typically ranges between INR 25,000 to INR 30,000. The final cost of anal fissure surgery can be different for each individual depending on various factors such as hospitalization charges, consultation charges of proctologists, choice of hospital, insurance coverage, cost of anesthesia, charges of an anesthesiologist, severity of the condition, cost of diagnostic tests, etc. 

    Usually, anal fissure surgeries are covered under health insurance, but you should ask your insurance provider about the coverage of your policy. 

    If you choose Pristyn Care for anal fissure treatment, our dedicated insurance team can help you in claiming your insurance on your behalf and make your treatment journey as easy as possible. 

    What are the Non-Surgical Treatment Options for Anal Fissure?

    Fissures can be treated at home by non-surgical treatments if it is diagnosed in their initial stage. Some non-surgical treatments for anal fissures are discussed below:

    Home Remedies 

    There are some home remedies and self-care tips that may relieve the pain and discomfort associated with mild anal fissures and allow them to heal properly. 

    • Aloe Vera: Apply aloe vera gel on the affected area for relief.
    • Sitz bath: Sit in warm water for 10-15 minutes a few times a day to reduce pain and discomfort. 
    • Cold compress: Use a cold compress to reduce swelling and inflammation.
    • Stay hydrated: Drink plenty of water or juices and take fiber-rich foods to keep your digestive system healthy and reduce the chances of hydration. 
    • Coconut oil: Apply coconut oil to the affected area for relief.
    • Petroleum jelly: Use petroleum jelly to lubricate the anus and reduce friction during bowel movements.
    • Witch hazel: Apply witch hazel to the affected area to reduce pain and itching.

    Ointments

    Here’s a list of the best ointments available in the market to relieve anal fissures discomfort. 

    • Shield Rectal Ointment: Sheild ointment is composed of allantoin, lidocaine, hydrocortisone acetate and zinc oxide. This ointment is very effective in relieving pain and discomfort associated with fissures. You can apply it 2-3 times a day. The cost of this ointment is INR 73 for 15g. 
    • Doctor Butler’s Fissure Ointment: It can give you immediate over-the-counter relief of anal burning and discomfort. This ointment is a combination of medical and herbal ingredients. The cost of doctor butler’s cream is INR 2458 for 28g.
    • Anovate cream: Anovate cream is used to relieve pain and discomfort of anal fissures. It contains beclomethasone, lidocaine/lignocaine and phenylephrine. The cost of anovate cream is INR 97 for 20g. 
    • Lignocaine Gel for Fissure: Lidocaine is the most commonly prescribed topical anesthetic for anal fissures. It contains Alcuronium, Amphotericin B, Amprenavir etc. the cost of lignocaine gel is INR 30 for 10g. 

    Medications 

    • Lidocaine is the most commonly prescribed topical anesthetic for anal fissures.
    • For chronic anal fissure treatment, the first-line medication used to relax the anal muscles is topical nitroglycerin.

    What are the Signs of a Healing Fissure?

    With surgical or non-surgical treatment, anal fissures heal over time. Here are some indications which show that the fissure is healing.

    • Reduced pain or no pain during bowel movements.
    • Decreased bleeding during bowel movements.
    • Improvement in itching or irritation around the anal area.
    • Smaller fissure size or closure of the fissure.
    • Reduced discomfort during sitting or prolonged standing.
    • Increased ability to pass stool without straining or pain.
    • Decreased frequency of bowel movements.
    • Better digestion and absorption of nutrients.
    • Improved energy levels and overall health.
    • Increased confidence in daily activities.

    What Happens if Anal Fissure is Left Untreated?

    If left untreated, anal fissures can lead to chronic pain and discomfort and various serious complications.

    • Over time, untreated anal fissures can cause scar tissue to form, which can make bowel movements even more painful.
    • In severe cases, untreated anal fissures can lead to infections and abscesses in the anorectal path.
    • If left untreated, anal fissures can cause persistent pain and discomfort.
    • The pain may worsen during bowel movements and can last for hours afterward.
    • In some cases, anal fissures can cause bleeding during bowel movements.
    • The bleeding may be bright red or dark red and can be accompanied by pain.
    • If anal fissures are left untreated, they can lead to the formation of a fistula.

    To avoid complications, it is important to seek medical treatment for anal fissures as soon as possible.

    What Foods You Should Eat If You Have An Anal Fissure?

    Maintaining a healthy diet is always beneficial. Here are some foods that you should add to your diet to relieve anal fissure discomfort. 

    • Take high-fiber foods such as fruits and vegetables can help prevent constipation as constipation can worsen your anal fissures.
    • Whole grains like brown rice, quinoa, and whole wheat bread can also help with regular bowel movements.
    • Lean protein sources such as chicken, fish, and tofu can provide necessary nutrients without causing discomfort.
    • Low-fat dairy products like yogurt and milk can be beneficial for digestion.
    • Drink plenty of water throughout the day to keep stools soft and easy to pass.
    • Nuts and seeds such as almonds, chia seeds, and flaxseeds can provide healthy fats and fiber.
    • Herbal teas like chamomile or peppermint can help soothe the digestive system and reduce inflammation.
    • Olive oil and other healthy fats can help lubricate the digestive system and prevent irritation.
    • Sweet potatoes and squash can provide important vitamins and nutrients without causing discomfort.

    What Foods You Should Avoid If You Have An Anal Fissure?

    Here are some foods you should avoid if you have anal fissures, as they can alleviate pain and discomfort. 

    • Spicy foods can irritate the anal lining and worsen the condition of anal fissures.
    • Citrus fruits and juices might cause discomfort and exacerbate anal fissure symptoms.
    • Avoid consuming foods that are high in fat, as they can slow down the digestive process and lead to constipation, which can aggravate anal fissures.
    • Processed foods can be difficult to digest and may contribute to constipation, which can worsen anal fissures.
    • Fried foods are high in fat and can cause digestive issues, leading to constipation and worsening anal fissures.
    • Avoid consuming dairy products such as cheese and milk as they can cause constipation and make anal fissures worse.
    • Red meat is difficult to digest and can cause constipation, which can worsen anal fissure symptoms.
    • Nuts and seeds can cause irritation in the digestive tract and worsen anal fissures if consumed in large amounts.
    • Spicy condiments like hot sauce and chili paste can irritate the anal lining and make anal fissure symptoms worse.
    • Avoid drinking alcohol as it can dehydrate the body and lead to constipation, which can worsen anal fissures.

    FAQs around Anal Fissure

    How can I treat anal fissures at home?

    You can treat anal fissures to some extent with the help of the following:

    • Taking regular sitz bath to help relax the anal muscle and help irritation
    • Over-the-counter stool softeners
    • Drinking adequate amounts of water and improving digestion
    • Eating more fiber in your diet and taking fiber supplements.

    Which is the best ointments/Cream For anal fissures?

    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.

    When should I consult a doctor for anal fissure treatment?

    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.

    What is the best treatment For anal fissures?

    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.

    What are the risks of anal 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: 

    • Bleeding: Although very rare to occur, there is a possibility of hemorrhage or bleeding during the surgery of an anal fissure. 
    • Incontinence: Several patients report suffering from temporary incontinence immediately after the surgery. The problem is not likely to remain for more than 2-3 weeks and can remain until the patient recovers completely. 
    • Perianal abscess: Though the complication is not very common, some people have suffered from an abscess and also developed an anal fistula after the surgery of an anal fissure. 
    • Tear extending to the surrounding muscle: Damage to the anal sphincter or surrounding muscle or nerves can be due to direct thermal or mechanical trauma, and some infections develop later.
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    Dr. Falguni Rakesh Verma
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    Last Updated : February 24, 2024

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      Met Dr. Vikranth Suresh. Excellent knowledge. Outstanding listening skills. Doesn't rush you into surgery. Completely patient oriented, not money oriented. Listens to your case thoroughly and gives proper, step-wise guidance on what to do, what to not do, and how to proceed. Thanks Dr. Vikranth, Thanks Pristyn.

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      Taking this opportunity, I would want to share my thoughts regarding Prystine treatment Hospital, laser surgery, post-surgical treatment, and Doctor Prudhvinadh. After more than a year of pain, it was discovered that my wife had chronic fissures. After going through so much pain for so long, we looked into surgical possibilities even though we wanted to avoid it. We met Dr. Prudhvinadh through Prystine Care, following consultations with numerous physicians and medical facilities. In this area, Dr. Prudvhinadh has extensive expertise and profound knowledge. After assessing the case during our initial meeting, he calmly and patiently went over everything with us, including the surgical procedure. We returned back stating we will think again and get back. We have once more sought a second opinion from a few other medical professionals, gone over numerous client testimonials, and watched films of individuals who had this laser surgery and their recovery. We ultimately chose to proceed with this laser surgery after considering the effectiveness of Dr. Prudhvinadh as well as the opinions of his patients. The entire procedure was handled expertly and smoothly by Prystine Care Administration, from her hospital admission to her operation and eventual discharge. Dr. Prudhvinadh had given explicit instructions on what to do after surgery, including what to eat and take medication. Believe me, recovering from surgery was a very difficult process. We took great care to adhere to the prescribed dosage and food plan. I also made the decision to eat the same meal—completely devoid of spice—as my wife in order to support her. Food is just as important as medicine in this healing process. Our first post-operative appointment was scheduled for one week following the procedure, and the next one was scheduled for four weeks later. However, we chose to schedule two additional visits with the doctor, who was very accommodating and used his patience to offer advice and moral support to us. That was a huge assistance in maintaining the proper diet and attitude while taking the medication. After a thorough examination at her most recent visit, the doctor declared that she was perfectly normal, that she could stop taking her medication, and that she could resume eating her typical diet, which includes spices. After the procedure, my wife has been extremely well for the past three months. Given the age factor, we chose to switch our eating habits to food with very little spice, even though the doctor advised that it is okay to follow a normal spice food diet. My family and my wife are my main sources of strength. I sincerely appreciate Dr. Prudhvinadh's unwavering support and assistance during this entire surgical and recuperation process.I'm relieved right now and gladly suggest him to others as well.

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