Anal Fissure

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What is Anal Fissure ?

1) Intersphincteric fistula 2) Transsphincteric fistula 3) Suprasphincteric fistula 4) Extrasphincteric fistula

All that you need to know about anal fissure

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An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. Doktors are here to help you with best doctors along with high advanced technology treatment.


What is an anal fissure?

Anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter).

Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths. Some people with anal fissures may need medication or, occasionally, surgery.


Types of anal fissures

Mainly there are two types of anal fissures

  1. Acute anal fissure: which clears up within six weeks. This is the most common type, and normally appears as linear with clear edges.
  2. Chronic anal fissure:which persists for more than six weeks. Chronic anal fissure healing time varies.


Causes

  • - Passing large or hard stools
  • - Constipation and straining during bowel movements
  • - Chronic diarrhea
  • - Anal intercourse
  • - Childbirth
  • - Crohn's disease or another inflammatory bowel disease
  • - Anal cancer
  • - HIV
  • - Tuberculosis
  • - Syphilis

Symptoms

  • - Pain, sometimes severe, during bowel movements
  • - Pain after bowel movements that can last up to several hours
  • - Bright red blood on the stool or toilet paper after a bowel movement
  • - A visible crack in the skin around the anus
  • - A small lump or skin tag on the skin near the anal fissure

Diagnosis

Tests

  • - Anoscopy. An anoscope is a tubular device inserted into the anus to help your doctor visualize the rectum and anus.
  • - Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer.
  • - Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea.

Risks

  • - Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.
  • - Childbirth. Anal fissures are more common in women after they give birth.
  • - Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.
  • - Anal intercourse.
  • - Age. Anal fissures can occur at any age, but are more common in infants and middle-aged adults.

Complications

  • - Failure to heal. An anal fissure that fails to heal within eight weeks is considered chronic and may need further treatment.
  • - Recurrence. Once you've experienced an anal fissure, you are prone to having another one.
  • - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure.

Prevention of anal fissure

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For fissures in infants:

  • - Change diapers frequently.
  • - Treat constipation, if that is found to be the cause.

For fissures in adults:

Ø  Keep the anorectal area dry.

Ø  Wipe the area with soft materials, a moistened cloth, or cotton pad. Avoid rough and scented toilet paper.

Ø  Promptly treat all occurrences of constipation and diarrhea.

Ø  Avoid irritating the rectum.

Ø  Get plenty of fiber: If you're constipated, passing large, hard, or dry stools can cause an anal fissure. Getting plenty of fiber in your diet -- especially from fruits and vegetables -- can help prevent constipation, though.

  • - Wheat bran
  • - Oat bran
  • - Whole grains, including brown rice, oatmeal, popcorn, and - whole-grain pastas, cereals, and breads
  • - Peas and beans
  • - Seeds and nuts
  • - Citrus fruits
  • - Prunes and prune juice

If you can’t get enough fiber through your diet, try fiber supplements.

Whether you eat more fiber-rich foods or take supplements, boost your intake gradually until you notice softer, more-frequent bowel movements. Also, drink plenty of liquids as you take in more fiber. This will help you avoid bloating and gas.

Ø  Stay hydratedThat can help you prevent constipation. Drinking plenty of liquids adds fluid to your system, which can make stools softer and easier to pass. Be sure to drink more when the weather gets warmer or as you become more physically active.


Foods that are beneficial for anal fissure:

- Wheat bran.

- Oat bran.

- Whole grains, including brown rice, oatmeal, popcorn, and whole-grain pastas, cereals, and breads.

- Peas and beans.

- Seeds and nuts.

- Citrus fruits.

- Prunes and prune juice


When to consult a doctor for anal fissure treatment?

If you have an anal fissure, you may be referred to a doctor who specializes in digestive diseases (gastroenterologist) or a colon and rectal surgeon.


Treatment option & cost

Non- surgical treatments

  • - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe.
  • - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
  • - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
  • - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects.

Surgical treatments for anal fissure

If your anal fissure does not go away with medicinal treatments or any other treatment methods, it could be an indication of chronic anal fissure. In that case, the proctologist may recommend you undergo surgery for permanent treatment for anal fissure. 

- Open surgery – In open surgery, the anorectal surgeon makes a small incision in the anal sphincter to relax the anal muscle. Once the muscle is relaxed, it lets the anal fissure heal. Open anal fissure surgery is a conventional treatment procedure that comes with a certain amount of risks and complications, permanent incontinence being the most common one. 

- Laser surgery – During the procedure, the fissure doctor first administers local or general anesthesia to the patient. The doctor uses a laser probe to emit infrared radiation or laser beams at the surgical site [location of anal fissure]. The high-energy laser beams increase the blood flow to the area of the fissure and promote quick and proper healing of the fissure.


Preparation for anal fissure surgery

Before undergoing the surgery, it is important to make sure that you follow all the tips and advice from the doctor. Some of the tips for surgery preparation may include the following:

It is highly likely that the fissure doctor will tell you everything about the treatment procedure. All you need to do is follow the instructions diligently. If you are allergic to any medication, let the doctor know in advance.


  • - Quit drinking alcohol and smoking cigarettes at least a week before the surgery. This will help you recover and heal after the surgery quicker and in a much efficient manner. 
  • From the night before the surgery date, try to avoid eating heavy or large meals.
  • - On the day of the surgery, leave your valuable items at home while coming to the hospital.
  • - Get someone along with you while coming to the hospital for surgery who can help you drive home as you will not be allowed to drive.
  • - Get answers to all your questions about the surgery from the attending doctor or the surgeon.
  • - Before undergoing surgery, make sure either you or your guardian signs the consent form.

What to except after the surgery

Sphincterotomy, you may experience some mild to moderate pain or discomfort in your rectal area.You may also experience constipation, difficulty urinating, and possibly some rectal bleeding. The following are some general guidelines for proper care after your procedure.


After the anal fissure surgery

Avoid strenuous activity for 1 week after your procedure. Take sitz baths (sit for 15-20 minutes in warm water) three times a day and after each bowel movement for the first few days. Don't worry if you have some bleeding, discharge, or itching during your recovery. This is normal.


Recovery time line

It is important to note that complete healing with both medical and surgical treatments can take up to approximately 6-12 weeks. However, acute pain after surgery often disappears after a few days. Most patients will be able to return to work and resume daily activities a few short days after the surgery.

The medical coordinator understand the patient's problem on your first meet and advice's the best treatment for your problem. And starts scheduling your OPD and helps to connect the doctor based on your problem

DOKTORS only perform the advance scheduled surgeries, it doesn't provide any kind of emergency surgeries or treatments.

DOKTORS is not any hospital owner, it collaborates with other hospitals to perform surgeries which are done by doctors/surgeons using the medical infrastructure of the affiliated hospitals.

DOKTORS always provide online consultations, patients can select a doctor based on their specialization from anywhere based on the available slots. Patients can talk to the doctor through online call or chat to share their health problem. The doctor identify the problem and suggest the tests and medications as they require.

DOKTORS doesn't provide any insurance. Insurance is based on the type of conditions given by insurance provider. Our insurance team gets maximum help to get benefits.

There is an option to get second medical check up by highly reputated doctors for all kinds of problems. The consulted doctor can check all the previous medications and reports and can guides the new treatment.

While in the case of surgery the caretaker should be mentioned to patient who takes care in every moment in the whole surgery.

What happens if you delay the treatment/surgery?

Delayed treatment may aggravate piles and may lead to complications. Surgery is advised in case of

Severe pain

Prolonged bleeding

Large haemorrhoids

Alteration in bowel movements

Alteration in bowel movements

Why Doctor Care ?

Expert surgeons

We have the finest and some of the most qualified surgical specialists, each with 10+ years of experience, who will consult with you to determine and conduct the most appropriate surgical procedure for your condition.

Advanced Surgical Technologies

We have the finest and some of the most qualified surgical specialists, each with 10+ years of experience, who will consult with you to determine and conduct the most appropriate surgical procedure for your condition.

Personal Care Assistants

We have the finest and some of the most qualified surgical specialists, each with 10+ years of experience, who will consult with you to determine and conduct the most appropriate surgical procedure for your condition.

Financial aid and assistance

We have the finest and some of the most qualified surgical specialists, each with 10+ years of experience, who will consult with you to determine and conduct the most appropriate surgical procedure for your condition.

Postoperative Care

We have the finest and some of the most qualified surgical specialists, each with 10+ years of experience, who will consult with you to determine and conduct the most appropriate surgical procedure for your condition.

FAQ



What is the difference between piles and fissures?

Piles are mainly the swollen blood vessels while fissures are kind of cracks and fistulas are an opening of a cavity. Piles are mostly painless and unnoticeable. Fissures cause a lot of pain. In the case of fistulas, pus is discharged out of the anal area.

Can anal fissure cause piles?

Piles or haemorrhoids are inflamed veins in the rectal or anal region that may protrude outside, causing discomfort. An anal fissure, on the other hand, is a small cut on the lining of the anal cavity.

Can anal fissures cause cancer?

Anal fissures do not increase the risk of colon cancer nor cause it. However, more serious conditions can cause similar symptoms. Even when a fissure has healed completely, your colon and rectal surgeon may request other tests. A colonoscopy may be done to rule out other causes of rectal bleeding.

What are the best ointments to treat anal fissures?

Ø  Ointment that contains nitroglycerin like Rectiv

Ø  Ointment that contains topical anesthetics [lidocain, etc.] like Xylocaine

Ø  These can help in increasing the blood flow to the fissure and can promote healing and relieves the pain.

What is the difference between anal fissure and fistula?

The difference between piles and fistula and fissure is that a fissure is the tearing of the anus lining whereas a fistula is an abnormal connection between the anus and the skin.

How do anal fissures look like?

An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has a deeper tear, and may have internal or external fleshy growths. A fissure is considered chronic if it lasts more than eight weeks

What is a chronic anal fissure?
A chronic anal fissure likely has a deeper tear, and may have internal or external fleshy growths. A fissure is considered chronic if it lasts more than eight weeks.
Are anal fissures hereditary?

No, anal fissures are not hereditary

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Treatment Specialities Of Doktors

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Proctology – Laser Treatment for Piles, Fissure, Fistula, Pilonidal Sinus

Laparoscopic Surgery – Laparoscopic Treatment for Gallstone, Hernia

Vascular – Surgical and non-surgical treatments for Varicose veins, Spider Veins, Varicocele, Uterine Fibroids / DVT – Deep Vein Thrombosis, Diabetic Foot Ulcer

Urology – Phimosis, Hydrocele, Kidney stones, Urinary tract infections

Gynaecology & Obstetrics – Aesthetic Laser treatments / General Gynaecology Treatments / Cosmetic Gynecology Treatments / Surgical Gynecology Treatments, and Medical and Surgical Abortion

ENT – Surgical treatments for Sinusitis (FESS), Deviated Nasal Septum (Septoplasty), Perforated Eardrum (Tympanoplasty), Tonsillitis (Tonsillectomy), Adenoids (Adenoidectomy)

Aesthetics – Plastic Surgery for Gynecomastia, Hair Transplantation, Liposuction, Breast Surgery (Breast Augmentation and Breast Reduction)

Orthopedics Surgery – Treatments for ACL Tear, Carpal Tunnel Syndrome, Hip Replacement and Knee Replacement

Ophthalmology – Treatment for Cataract and LASIK

Fertility – IVF, IUI, Treatments for Male and Female Infertility

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