Anal fissure is a common disease that affects people of all ages.
An anal fissure is a tear of the anal skin that cause itching, discomfort, bleeding, and dull pain during and after defecation.
It can be acute or “short – term”, which heals by itself in few days, and chronic or “long – term” with no healing in 12 weeks.
When a patient has a chronic anal fissure, and a proper medical therapy has been already attempted, surgery is advised.
What causes an anal fissure?
Anal fissures can be caused by:
In fact, the extra tension in the two muscular rings (sphincters) controlling the anus may cause fissure as well. The outer anal sphincter is under your conscious control but the inner sphincter is not. This muscle is under pressure, or tension, all of the time for keeping the anal canal closed. If the pressure increases too much, it can cause spasm and reduce blood flow to the anus, leading to a fissure. This pressure can also prevent the fissure from healing.
What are the symptoms?
Treatment for anal fissure:
Initially, medical therapy with special local ointment, stool softener and pain killers is attempted.
If the fissure is not healing in 3 months and scar tissue is forming, then surgery is the only way to guarantee healing to the patient.
Normally, surgical cauterization (diathermy) under sedation is the only necessary treatment. Contextual sentinel polyp asportation is mandatory.
In more advanced cases, anal flap fashioning is necessary in order to make the fissure healing correctly.
In the few cases where the muscle spasm is the main causative component, a little incision on the inner sphincter might be necessary, always taking utmost care to safeguard the continence.
All the procedures are performed with minimally invasive techniques, allowing the patient to be operated in a Day Surgery setting, with less pain and quick return to daily activities.
*anal fissure treatment