Anal fissures are caused by a small tear in the anal region. An anal fissure causes severe pain and blood spotting during bowel movements.
So, if you are facing any of these symptoms, could this be an Anal fissure?
Anal Fissures are very common in India, and their incidence varies substantially among different ages and sex. Male, Females and children are equally prone to this problem.
Why me? What are the causes of Anal Fissures?
- Severe Constipation and straining during bowel movements.
- Fissures are common during pregnancy and childbirth in the last trimester of pregnancy and one month after delivery.
- Persistent Diarrhoea
- Inflammatory bowel diseases (IBD) like Crohn’s disease and ulcerative colitis.
- Infection from syphilis or herpes, commonly known as sexually transmitted infections (STI).
- Tight constraining in the anal sphincter muscles can cause tension and tear in the anus.
Any of these factors are the triggers for anal fissure.
Do I need a doctor’s visit?
Most anal fissures are minor and heal on their own. But Anal fissures that show symptoms even after 4- 6 weeks need a medical Intervention or a doctor visit, as they are prone to become Chronic Anal Fissures!
What are Chronic Anal fissures?
Fissures generally result from stretching your anal muscle beyond its standard capacity. Once the tear develops, it leads to repeated injury and a cycle of injury, leading to Recurrent Anal Fissures.
The exposed internal sphincter muscle beneath the tear goes into spasm, and you may undergo extremely painful bowel movements. Also, the spasm pulls the edges of the Fissure apart, making the tear or Fissure difficult to heal. This spasm further leads to tearing of the anal muscles.
This vicious cycle leads to the development of chronic anal fissure, which doesn’t heal on its own.
When should I visit a doctor?
If the Anal fissures (AF) are not going away on their own, you should visit a doctor? Because if Anal fissures are left untreated, it may lead to the infection, and pus formation, eventually making the Fissure grow deeper and turning into a Fistula (an abnormal connection between the anal canal and the skin outside.)
Diagnosis of Anal Fissures
A physical exam confirms most Anal Fissures a doctor. Your doctor may recommend further tests if he thinks it could be due to an underlying condition. The various test he could prescribe for AF confirmation is-
- Flexible Sigmoidoscopy
Treatment options for the Anal Fissures
Depending upon the severity and chronicity of the Anal Fissure, the doctor may suggest you take different treatments.
Non Surgical treatment options for Anal FIssures
If the Anal Fissures are not chronic, the various treatments aim to heal and ease the dreadful pain. For Example-
- Externally applied nitroglycerin ointment
- Topical anaesthetic creams
- Botulinum toxin type A (Botox) injection
- Blood pressure medications
But if the diagnosis by the doctor reveals your condition to be a Chronic one, then it may be possible that the doctor may suggest you undergo Surgery.
Various Surgical treatments for Anal Fissures
- Internal Sphincterotomy
- V- Y advancement flaps
Which one is best for you?
A lateral Internal Sphincterotomy (LIS) is the most preferred surgical technique for Chronic anal Fissures. According to Delhi NCR, top general surgeons say more than 90% of chronic anal fissure patients heal effectively after a lateral internal sphincterotomy( LIS ) surgical procedure. Although, many also prefer laser surgery for fissure treatment.
What is Laser surgery for Fissure?
It is the most sought-after procedure for fissure treatment. It is generally performed under general anaesthesia. It can provide minor relief and pain from the anal Fissure.
The benefits of this procedure are
- Pain-free Surgery for fissures
- Minimal invasive in nature
- No Bleeding
- Quick recovery, you can go home the same day.
- The recurrence rate is 0
- The lowest chance of operation-related infection
What is lateral internal sphincterotomy (LIS) surgery?
If your Fissure is diagnosed as a chronic one and other treatments have failed to address them, doctors perform lateral internal sphincterotomy (LIS). This procedure involves cutting a small portion of the anal sphincter muscle to your spasm and pain to promote healing.
What is the Recovery and Post Surgery Care you may need?
Like any other surgery, the fissure operation also takes time for the patient to recover.
The Surgery has a minimum downtime of 3 – 4 days and a maximum of 7 days. Post this recovery period; the patient can resume normal activities.
Most patients report that the anal fissure discomfort they previously suffered has dissipated. While it is common to have some discomfort with bowel movements initially after Surgery, the pain is often less severe. You may detect a tiny amount of blood on the toilet paper after a bowel movement for the first few weeks.
Is Surgery Necessary for a Fissure?
Most Fissures do not require surgeries. But if it becomes chronic, surgery is the only option for its treatment. Chronic Anal fissures cause severe pain and blood spotting. Anal fissures, if left untreated, can turn to pus formation or infection in the Fissure. The Fissure may turn into a fistula if no treatment is taken for its healing.
Your anal Fissure will get more difficult to cure if you delay its treatment.
At HexaHealth, we provide the best doctors in India for fissure treatment. It has a network of reputed doctors in hospitals who give the most advanced treatment options for fissure treatment. Please feel free to contact us and tell us your problem with it!