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What are fissures ?

Anal fissures are painful cracks or tears that occur in the lining of the distal anal canal located between the rectum and the opening through which stools are passed. Initially, fissures develop only in the epithelium but later can involve the full thickness of the anal mucosa. They tend to evolve in both men and women and more in the younger and middle-aged population.

Anal Fissure Treatment in Kochi

Anal Fissure Causes

  • Injury or trauma to the anal canal due to :
    • Chronic constipation
    • Frequent diarrhea
    • IBD or inflammatory bowel disease
    • Decreased flow of blood in the anal area
    • Straining during child birth
    • Spastic or tight anal sphincter muscles
    • Anal cancer
    • Tuberculosis
    • Syphilis
    • HIV
    • Herpes

Anal Fissure Signs and symptoms

  • Sharp pain during bowel movements
  • Pain lasts for several hours after a bowel movement
  • Bleeding
  • Itching
  • Dark red blood mixed with stools
  • Sometimes painless with no healing of wound bleeding from time to time

Anal Fissure Diagnosis

  • Lab studies :
    • HIV test
    • Stool culture and viral culture tests
    • Biopsy of the fissure
    • Erythrocyte sedimentation rate
  • Digital rectal examination
  • Anoscopy and proctosigmoidoscopy: recommended for patients who have recurrent anal fissures even after surgery

Anal Fissure Treatment

  • Medical therapy :
    • Stool bulking agents:
      • Fiber supplementation
      • Stool softeners
    • Laxatives for regular bowel movements
    • Mineral oil for passage of stool without abrasion of the anal mucosa
    • Sitz baths
    • Intra-anal application 0.4% nitroglycerine or glycerol trinitrate ointment into the internal sphincter
    • Local botulinum toxin injections for acute and chronic fissures
  • Surgical therapy :
    • Lateral internal sphincterotomy:
      • Procedure of choice
      • Performed under general anesthesia
      • The atrophied internal sphincter is cut away releasing tension
      • Closed sphincterotomy uses a no. 11 blade sideways to make a small incision
      • Open sphincterotomy requires 0.5 cm to 1 cm incision

Dr. Zubin Jacob performs elective surgery of fissures after careful and meticulous evaluation of the illness.

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