Surgery is a very effective treatment for a fissure and recurrence rates after surgery are low. Other medical problems can cause symptoms similar to fissures and need to be ruled out in cases of persistent anal pain. If fissures recur without explanation, or fail to respond to treatment, further assessment may be warranted. Patients need to continue good bowel habits, including following a high fiber diet, after a fissure has healed because fissures can recur easily. Botox injections are also a treatment option for stopping spasms and pain. Occasionally, a topical muscle-relaxing cream is prescribed to relax the sphincter muscles. (Increased dietary fiber may also help to improve diarrhea.) Warm baths for 10-20 minutes relax and clean the area, promoting healing. Conservative management of fissures includes maintaining a high fiber diet bulking agents, stool softeners, and extra fluid intake will also help soften bowel movements, relieve constipation and allowing for healing. An acute fissure is typically managed conservatively, with over 90% healing without surgery. Treating constipation or diarrhea can oftentimes allow for healing a fissure. Chronic fissures often have a small lump known as a sentinel pile or skin tag. ![]() Anal fissures may be acute (recent onset) or chronic (present for a long time or recurring frequently). Pain may be so intense as to cause severe constipation from avoidance of having a bowel movement.Īnal fissures are cause by trauma, i.e., anything that can cut or irritate the inner lining of the anus-most typically, a hard, dry bowel movement-or diarrhea or anal inflammation. Symptoms of an anal fissure are pain and/or bleeding after a bowel movement. While common, fissures are often confused with other causes of pain and bleeding, such as hemorrhoids. However, all the options should be presented to the patient with complete information about the method, cure rates, complications, and reversibility of the complications and the final choice should be left in his hands.An anal fissure, the most common cause of anal pain, is a small cut or tear in the lining of the anal canal. Both methods are easy to perform, have negligible complications and no special setup is needed, except the radio surgical unit, in case of the first procedure. Revisiting the trends of treatment of chronic anal fissures, the most preferred options are the manual dilatation with radio surgery and the subcutaneous lateral anal sphincterotomy. The addition of radio surgery is found useful for refreshing the edges of the fissure and to tackle pathologies namely sentinel pile, small internal piles or hypertrophied anal papillae often found associated with chronic fissures. A new method combining the age-old technique of Lord's manual dilatation followed by radio surgery is also highlighted. About 10 different techniques are presented in brief with their efficacy and fallacy. To date, lateral sphincterotomy has been favoured by most of the proctologists, because it is the least extensive surgical procedure and is offering a long lasting relief in sphincter spasm. ![]() The efficacy claimed by each of the prevalent method is very high but the inconsistencies and contraindications are equally strong. ![]() Some of them are non-surgical while the others are surgical. There are many options to treat chronic fissures in ano.
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