Fissure

TYPES OF FISSURE:

1. An acute anal fissure lasts for less than six weeks. 2. A chronic anal fissure has symptoms for longer than six weeks. 3. A primary anal fissure has no identifiable cause. 4. A secondary anal fissure has an identifiable cause.

Symptoms of Fissure:

1. Pain and a long deep burning sensation is caused while passing stools.
2. Stools are red as they contain fresh blood.
3. Cracks in the anal skin is visible.
4. Itching and discomfort around the anus.
5. Pus may occur on the anal fissure.
6. Discomfort while urinating, some patient might tend to urinate more frequently, due to a related condition known as dysuria.
7. A small skin tag on the skin near the anal fissure.

Causes of Fissure:

1. Sexually transmitted Infections.
2. Anal Sex.
3. Muscle Spasms.
4. Constipation.
5. Crohn’s disease, Ulcerative Colitis and other inflammatory bowel diseases may occur ulcers in the anal region.
6. Pregnancy and child birth: during delivery, the line of the anus can tear and cause anal fissures.
7. Prolonged diarrhea.

Diagnosis of Anal Fissure:

A doctor can diagnose the fissure after a physical examination of the anal area.

Rectal Exam: It involves inserting a finger or a small instrument into the rectum, which is painful. A specialist will use anesthesia on the area before the rectal examination.

Sigmoidoscopy or colonoscopy: A flexible viewing tube is used to inspect the insides of the anus and rectum. This diagnostic test may be ordered if the doctor wants to rule out more serious anal diseases.

Treatment of Fissure:

In most of the cases, an anal fissures take around a few weeks to heal. Patients should make sure that they replenish themselves with water and natural juices.

Nitrate Ointment: Nitrate ointments help in the healing process by increasing the flow of blood. This helps to reduce inflammation around the area and decrease itching sensations and pain.

Chemical Sphincterotomy: It is a non-operative painless technique that uses injections to cure fissures.

Internal Sphincterotomy: This surgery is required for chronic anal fissures which does not heal with other methods. A portion of the anal sphincter muscle is surgically removed, resulting in fewer and less severe spasms.

Fissurectomy: This is a surgical procedure is rare and can be used for children. It involves the removal the fissure.

Pilonidal Sinus: A Pilonidal Sinus is a small sac or tunnel in the skin that develops over the tailbone at the top of the cleft of the buttocks.It usually contains hair and skin debris.Commonly found in men,It is characterized by a painful swelling in the area that oozes pus and blood.For years,treatment of Pilonidal sinus was an arduous process for the patients with a lengthy healing time.However,the advent of laser (Laser Pilonidoplasty)has brought hope of a faster recovery encouraging patients to seek treatment.

Rectal Prolapse: Rectal Prolapse is a condition in which the rectum (i.e. the last few inches of the large intestine) or a part of it, loses its normal attachments inside the body, and protrudes out through the anal opening. Depending on the degree of prolapse treatment options include:

1 STARR Surgery
2 Thiersch’s procedure
3 Rectopexy

Anal fissures can be prevented by:

1 A well-balanced diet consisting of plenty of fiber.
2 Consumption of a lot of water and other fluids.
3 Going to the toilet, when you feel like it.
4 Changing diapers frequently for babies.
5 Regular exercise which helps reduce the risk of constipation.
6 Staying hydrated during and after exercise.
7 Avoiding sitting on the toilet for long periods of time.
8 Avoiding the use of rough or perfumed toilet papers.