Occasionally, especially for chronic or recurrent fissures, botox injection may be useful. In this technique, a small amount is divided in a controlled manner under anaesthesia to promote fissure healing. However, once it shows signs of chronicity (scarring and sentinel pile) or having failed the above treatment, an effective surgical technique is the Lateral Anal Sphincterotomy. At the same time, stool softeners are prescribed to minimize trauma during bowel movements. The most effective treatment for acute anal fissure is the use of GTN ointment to relax the anal muscle and relieve spasms. The principle of treatment is to break the cycle of pain and spasms, so as to allow healing of the fissure. ExaminationĪn acute fissure has the appearance of a simple tear in the anus skin, but after 6 to 8 weeks it becomes chronic and may cause swelling and scarring and an external lump along called a sentinel pile. As such, it is important to seek the right attention early in order to get the right treatment. But these are 2 entirely different conditions requiring different treatments. This consequently sets up a vicious cycle, which results in more tightening and reduces the blood flow to the injured area which slows healing.Ĭommonly, patients may be misdiagnosed as having hemorrhoids because both have common symptoms. More effort is needed for bowel movements which can cause more straining and tearing. The pain results in tightening of the anal sphincter (spasm) which causes an increase in sphincter pressure. Occasionally excessive trauma from repeated bowel movements like diarrhoea and loose stools can also cause it. Usually, using excessive force (straining) at stools, accompanied by a hard bowel movement is responsible for the fissure. The pain may last for a minute to several hours. The patient classically experiences severe pain (sometimes described as passing glass shards) during the bowel movement along with some bleeding. Pain and bleeding are the most common symptoms of a fissure. Those who have multiple fissures or fissures located in unusual locations may have an underlying disease (eg. ![]() ![]() Sentinel pile was present in 63.5 patients in DTZ group and in 54 patients in. Majority (85 to 90%) of anal fissures occur in the back midline position of the anus as it is the weakest part of the anal skin. Topical diltiazem causes minimal side effects like peri-anal dermatitis. ![]() Although fissures are common, people usually get them confused with hemorrhoids.Īnal fissures can develop at any point of age and can happen to both males and females. A fissure is typically extremely painful and can be associated with bleeding during bowel movements. Anal Fissure is a tear in the anal skin which can extend into the anal canal.
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