Overall
Diagnosis
Treatment
Overall
An anal fissure is a longitudinal tear or tear in the lining of the anus or lower end of anal canal.
An anul fissure occur when you pass hard or long stool for long time. It is extreme painful condition. Hard stool causing a crack in the mucosa of anus.
An anul fissures are very commonly seen in infants and young people.
Acute anal fissure condition get recover with simple treatments that is add lots of fiber in your diet with water intake properly, that’s why your can pass smooth stool with out straining and water can help hydrate your body whole day.
TYPE
- Anterior part of anal canal (10%)
- Posterior part of anal canal ( 90%)
- Acute fissure in ano
- Chronic fissure in ano
CAUSES
- Constipation
- Untreated in acute condition it can may cause chronic fissure in ano
- Chronic diarrhea
- Repeated Child birth
- Anal intercourse
- Anal cancer
- Ischemia in anal canal
- Abuse of laxatives
- Sphincter hypertonia
- Haemorrhoidectomy
OTHERS CAUSES
- HIV
- Tuberculosis
- Crohn’s disease
- STD ( Sexually transmitted diseases)
- Leukaemia
SYMPTOMS
- Extrem pain during passing the stool
- This pain can stay several hour ofter passing stool
- Bright red blood line on stool or in toilet paper after passing the stool
- Burning sensation present
- Sphinter spasm
- In acute condition no itching present
- In chronic condition itching present due to ulcer
- Discomfort when urinating
- Sentinel pile present in chronic condition
OTHER SYMPTOMS
- Depression
- Anxiety
- Loss of sleep
- Loss of appetite
- Weight loss
Diagnosis
INVESTIGATION
- When you seen any symptom of fissure immediately consult with doc
- Per rectal examination
- Proctoscopy
Treatment
Medical:
- Medicine for pain relief
- Prevent constipation or hard stool
- Add lots of fiber in your diet
- Intake proper water per day
- Sleep properly
- Warm bath or sitz bath
- Avoid straining during stool
- Using petroleum jelly to help lubricant the anorectal area
- Metronidazole and antibiotics
- Glyceryl trinitrate – it reduces spasm, increase vascular perfusion
- purified botulinum toxin injection into internal spincter
- Nifedipine, Diltiazem
Surgery:
- Lateral anal sphincterotomy
- Fissurectomy and local flaps
- Blunt sphincterotomy Or Lord’s dialation
