Fissure in Ano
It is severe painful condition while passing toilet or stools due to tear or crack in anal canal.
People are mistaken with Piles or Hemmorhoids.
They are of 2 types
- Acute Fissure in Ano
- Chronic Fissure in Ano
Causes
- Hard stools & straining during toilet
- Constipation
- Diarrhea
- Obesity
- Pregnancy & after Delivery
- Low Fiber Diet
It can also be secondary to
- Crohn's disease
- Anal cancer
- HIV
- Tuberculosis
- Anal Sex
Symptoms
- Severe Burning Tearing pain
- Fresh red Blood streaked stools
- Itching
- Sentinel Skin Tag like Swelling at anus
Diagnosis
Assessment of patient is must
- Detailed History & Symptoms
- Digital Rectal Examination with finger
- Anoscopy if possible
Treatment
- Most of Acute fissure in ano heals spontaneously without surgery by home treatment like dietary changes , food tips, High fiber diet.
- Medicines
- Laxatives
- Warm Sitz Bath
- High Fiber Diet
- Adequate Water Intake
- Topical Ointments or Cream
It helps you to pass motion easily without friction & with Less pain.
- Whole grain cereals
- Oats
- Isapgul husk with milk / water
- Boiled vegetables, Salads like broccoli, cabbage, carrots
- Leafy Vegetables Like Palak, Methi, green Coriander
- Brown Rice
- Legumes
- Fresh Fruits Like apple, Mosambi, Orange
- Berries
- 1 cup of cooked quinoa
- Whole wheat Brown bread
- DRINK MORE WATER – atleast 8 glasses of water
- Chillies & Chili based powders, Garam Masala
- Chutney pastes
- Garlic
- Maida or refined wheat flour based items like bread, Pav , Biscuits
- Red Pepper
- Brinjal
- Pizza
- Chipotle dressing, jalapeno dressing, chili Sauces
- Coffee, Alcohol, cola aerated drinks
- STOP SMOKING
Apart from Dietary recommedations, Some Office based or OPD medical treatment may be needed in severe relentless painful conditions.
- Botox or Botulinum Injection ( Chemical Sphincterotomy )
- Nitroglycerine Ointment, Diltiazem ( Medical sphincterotomy )
- Pain Killers to decrease pain, anal spasm
- Laxatives & Stool Softeners
- Use Soft Baby wipes instead of toilet paper & Wipe gently after using toilet
These are temporary measures which relieves anal sphincter spasm , decreases pressure resulting in increased blood supply giving an opportunity for healing of fissure.
Long standing like Chronic Fissure or complicated Fissure in Ano after trying diet changes & medical treatment may need surgery or which fulfils below criteria
Above factors are less likely responders to conservative remedies & hence definitive permanent solution is required.
Surgery / Operation
Best treatment for Chronic fissure – Lateral Internal Sphincterotomy
Very high success rate.
Healing is seen in upto 95 to 98 % of patients.
- Lateral Internal Sphincterotomy – Open or Closed
- Laser Sphincterolysis or Sphincterotomy – Open or Closed
- Anal / Rectal Advancement – Flaps / Anoplasty – In Low Anal tone
- Fissurectomy
- Anal Dilatation – No Longer Recommended or Obsolete
Recovery
Fissure surgery is highly reliable with very high satisfaction & success rates.
Overall Complication rates are very Low as compared to other surgical treatment modalities.
They may occur as
- Immediate
Abscess
Temporary Incontinence
Infection or Abscess
Fistula Formation
2. Delayed or Late
Recurrence ( Less than 1 to 2 % )
Incontinence
Stool Softeners & Laxatives for 2-3 weeks
Follow Diet as instructed by your doctor
Chronic Fissure in Ano
Perianal Abscess
Fistula in Ano
Anal Stenosis
No. It does not lead to cancer.
Can present as anal ulcer which may mimick fissure but in reality might be anal cancer.
So it is always advisable to get it checked by your surgeon.
TESTIMONIALS
Get OPD Appointment
Book OPD appointment with Dr. Chintan B Patel at Kiran Hospital, Surat, Gujarat, India
Opening Hours
Monday – Saturday
Morning10.00 AM – 12.30 PM
Evening04.30 PM – 06.00 PM
