Although most anal fissures do not require surgery, chronic fissures are harder to treat and surgery may be the best option. The goal of surgery is to help the anal sphincter muscles relax which reduces pain and spasms, allowing the fissure to heal.
Surgery. If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your health care provider may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS). LIS involves cutting a small portion of the anal sphincter muscle.
Not all anal fissures require surgery. The majority can heal with the help of nonsurgical treatments, such as dietary changes, over-the-counter stool softeners, and topical creams.
People whose anal fissures don't heal well may have an imbalance in anal pressure that prevents blood from circulating normally through the blood vessels around the anus. The reduced blood flow prevents healing.
Continuous drainage and non-healing of the wound in some cases can lead to the formation of abscess and fistula. Although there are very fewer chances of developing such infections after surgery. Such wound complications might be some results of the infections that are not clinically evident.
Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position. This can make bowel movements easier after surgery. Use baby wipes or medicated pads, such as Tucks, instead of toilet paper after a bowel movement.
You should expect some pain and discomfort in your bottom (anus) after anal fissure surgery. The pain is usually worst during the first seven days after the operation and should get much better after this first week. It's going to be more comfortable for you to poo if your poo is soft.
Some people get fissures once in awhile and others can become chronic, lasting for years. The pain of a fissure may cause people to avoid having a bowel movement leading to chronic constipation.
Most people will fully heal within 2 to 4 weeks.
Anal fissures usually heal within a few weeks without the need for treatment. But they can easily come back if they're caused by constipation that remains untreated. In some people, symptoms from anal fissures last 6 weeks or more (chronic anal fissures).
Some of the common medications used to treat fissures include over-the-counter creams such as Preparation H®, hydrocortisone or zinc oxide. For prescriptions, doctors often recommend Rectiv® (nitroglycerin), Xylocaine® (lidocaine) or Botox® injections, which temporarily halt anal sphincter muscle spasms.
Although most anal fissures do not require surgery, chronic fissures are harder to treat and surgery may be the best option. The goal of surgery is to help the anal sphincter muscles relax which reduces pain and spasms, allowing the fissure to heal.
The operation usually takes about 15 minutes. Your surgeon will make a small cut on the skin near your back passage. They will cut the lower part of the internal sphincter muscle. This will relieve the spasm in the sphincter, allowing a better blood supply to heal the fissure.
Side effects may include: dizziness, lightheadedness, nausea, sedation, vomiting, if these side effects occur, it may help if you lie down after taking the medication. Avoid strenuous activity for 1 week after your procedure.
Because of the anus's high concentration of pain fibers, patients describe anal fissure pain as “razor sharp” or “like broken glass.” To avoid pain, patients may avoid defecation and become constipated, which aggravates the condition.
Acute fissures can become chronic, and sentinel pile can result. A permanent skin tag can result, and fistulas may form.
The pain may make it hard for you to have a bowel movement, causing constipation (having fewer bowel movements than usual). They can also cause bleeding from your anus. Anal fissures don't cause colon cancer or increase your risk of getting colon cancer.
“Anal fissure operation is a small procedure that can greatly improve your condition” emphasizes Dr. Amarchand.
This surgery relieves the pressure and allows the anal fissure to heal. This surgery may be done while you are completely asleep or while you are awake. If you are awake, you will be given medicine to help you relax.
Over-wiping with rough and dry toilet paper can lead to itching, pain, and bleeding. In fact, improper wiping is the leading cause of America's most common bum-related injury – anal fissures (aka anal tears). Other common problems include UTI's and hemorrhoids.
Piles are mostly painless and unnoticeable. Fissures cause a lot of pain.
Either can cause pain, itching and bleeding. However, if you are in pain and don't feel an external lump, the condition is more likely to be a fissure. If you notice that you are leaking mucus from your anus, the problem is probably a hemorrhoid.
Walking promotes overall good health. It lowers the chances of formation of hard stools and stimulates and promotes blood flow which is helpful if you have a fissure.