Anal fissure - Symptoms, Diagnosis, ointment and Treatment

Anal fissures can be caused by various reasons like chronic diarrhea, chronic constipation, injuries, and underlying conditions like Crohn’s disease, anal cancer, STDs, etc.

There are 2 main types of Anal Fissure:

• Acute: In this type of anal fissure, the tear looks like a paper cut and is more surface-level and can be treated with topical ointments, medications, a high fiber diet, and home treatments like sitz bath.
• Chronic: In chronic anal fissure, the fissure has a deeper tear accompanied by internal and external growths. If a fissure lasts more than 2 months, it is considered chronic. These types of fissures are better treated with surgery.

Anal Fissure Diagnosis

Pristyn Care proctologists are highly experienced and may diagnose an anal fissure with a physical examination. However, the doctor may prescribe additional tests to diagnose the condition correctly and rule out complications. The standard diagnostic tests for anal fissures include Sigmoidoscopy, Anoscopy, and Colonoscopy.

Anal Fissure Treatment

If your anal fissure doesn’t heal with medication and other treatments, it could indicate a chronic condition. Laser-assisted surgery is one of the most effective treatments for chronic anal fissures. During this procedure, the patient is first administered general or local anesthesia. Then, once he is asleep, the surgeon uses the laser probe that emits laser radiation to heal the tears in the mucosa. This treatment is a daycare procedure, and the patient can go home the same day unless the doctor advises otherwise.

While preparing for the surgery, it is essential to follow all instructions given by your doctor to ensure that your recovery process is on track. 

• Let your doctor know in advance if you’re allergic to any medications.
• Avoid heavy meals the night before the surgery.
• Avoid drinking and smoking a week before the surgery.
• Eat a light meal on the day of the surgery. Avoid heavy foods that are high in fats and carbs.

The recovery process after the anal fissure laser surgery varies for different individuals. It may take 30 to 45 days to recover from an anal fissure laser surgery completely. Therefore, in your first month of recovery, you must ensure the following:

• Avoid lifting heavy weights as that adds additional strain to the surgical site.
• Eat meals that are nutritious and high in fiber content. Avoid oily and fried foods.
• To ensure you are hydrated, drink at least 8-10 glasses of water every day. 
• Do not strain yourself during your bowel movement.
• If your bowel movements are hard, consider taking stool softeners to alleviate the strain (only after consulting the doctor).
• Be diligent about taking medications and applying ointments/creams prescribed by your doctor.

The following are the benefits of laser surgery for anal fissure treatment.

• Minimal Bleeding & Pain: There is minimal blood loss during laser surgery and reduced pain post-surgery since the laser only targets a specific area.
• Improved Precision: Laser surgery imparts precision by targeting smaller areas without damaging the surrounding tissues.
• Day Care Surgery: Anal fissure laser surgery is a day care surgery, i.e., you will be discharged the same day unless the doctor deems otherwise.
• Shorter Recovery Time: Since it is a minimally invasive procedure, the recovery time is much lesser.

A delay in treating anal fissures may cause further complications to your condition and reduce the quality of your life. Some risks that may occur are the following:

• Chronic fissures: An acute fissure may become a chronic condition if it is not treated on time. Fissures that continue to present for more than 6-7 weeks are considered chronic. Over time, this can cause extensive scar tissue at the site of the fissure (sentinel pile).
• Difficulty in passing stool: The fissure can make passing stool very painful due to the stretching of the anal mucosa.
• Tear extending to the surrounding muscle: Continuous strain and spasms can lead to the extension of the anal fissure into the internal anal sphincter.
• Incontinence: If the function of anal sphincter muscles is disturbed by a chronic fissure, it may lead to a certain level of incontinence.

Note: Patient details changed for privacy.

Rizwan, a 28-year-old male from Gurgaon, had been suffering from anal fissures for some time, making his daily life uncomfortable. He also suffered from constipation and didn’t get much relief from medication as his fissures would always return. Eventually,  his condition became chronic and resulted in severe pain daily. 

After in-depth research online, he came across Pristyn Care. He contacted Pristyn Care, and the medical care coordinator booked his appointment with Dr. Aman Priya Khanna after a detailed conversation. At his appointment, Dr. Aman took Rizwan through his condition and patiently answered all of his questions. He told Rizwan about his treatment options and suggested laser anal fissure surgery. Rizwan was very nervous about the idea of surgery as he had never had a surgical procedure done before. However, Dr. Aman and the medical care coordinator ensured Rizwan that the surgery would be the most efficient way to deal with his condition and reduce the recurrence risk. In addition, Dr. Aman informed Rizwan that the surgery would be painless and involve minimal blood loss. After this discussion, Rizwan felt at ease and decided to go for the surgery.

Pristyn Care provided free pick-up and drop cab services on the day of his surgery and took care of Rizwan’s documentation and insurance approval. As a result, he felt at ease and didn’t need to run around to get everything done. He had a smooth surgery with no complications and was discharged on the same day.

Rizwan fully recovered after his surgery, and his condition has not since recurred. Throughout his time with Pristyn Care, Rizwan felt supported and had a great experience overall.

The anal fissure surgery cost in India generally ranges between Rs. 25,000 to Rs. 30,000. This is the estimated anal fissure surgery cost and it can vary from person to person. The final cost is subject to vary based on some factors. In general, the following factors lead to a variation in the cost of laser fissure surgery in India:

• Consultation fees of the proctologist
• Choice of city & hospital
• Hospital admission charges
• The cost of anesthesia
• Fees of the anesthetist
• The severity of the anal fissure
• Cost of preoperative tests
• Charges of follow-up sessions