What is the prevention and cure for fissures?
What is Fissure?
A fissure is a narrow opening produced by cleavage or separation of parts. In medical terminology, a fissure is a tiny tear in the delicate, moistened tissue which lines the anus. The fissure happens probably when the person passes hard or large stools during a bowel movement. Anal fissures almost always cause pain and bleeding with bowel movements. Anal fissures are prevalent in young infants but can affect humans of all ages during diverse circumstances such as childbirth, diarrhoea, long bouts, and others. The fissure can also be caused by systemic malignancy, inflammatory bowel disease, tuberculosis, trauma, chemotherapy, etc.
Symptoms of Fissure
The varied signs and symptoms of anal fissures are:
- Pain and a severe burning sensation, especially when passing stools which can last for a few hours
- Stools are red and contain fresh blood
- Visible cracks in the anal skin
- Itching and distress around the anus
- Pus may occur on the anal fissure
- Pain while urinating, some patients might go to the restroom more often due to an associated ailment called dysuria
- A small lump or skin tag near the anal fissure
Can anal fissures be prevented?
As the old adage goes, ‘prevention is better than cure’. There are various precautions your doctor will advise you to follow to prevent the fissures from occurring possibly.
- Don’t keep the same diaper on for too long. Change them regularly.
- If constipation is identified to be the cause of fissures, take medical assistance immediately.
- The anorectal area should be kept dry at all times.
- Wipe the area with soft materials like a moistened cloth or cotton pad. Ideally, infant wipes without any fragrance are recommended as they are gentle on the skin and don’t cause any irritation.
- Get all instances of constipation and diarrhoea examined and treated by a medical expert.
- Avoid irritating the rectum.
- Going to the restroom whenever you feel the urge
- Avoiding sitting on the toilet for extended periods
How is fissure treated?
Anal fissure treatments aim to reduce the stress on the anal canal by making stools soft and easing pain and bleeding.
Conservative treatments are advised and tried first which include one or more of the following:
- Adding high-fibre foods to your diet, keeping yourself hydrated, and exercising regularly to keep from having to strain during bowel movements.
- Using a petroleum jelly to help lubricate the anorectal area.
These practices may end up healing almost 80 to 90 percent of the fissures within a few weeks to several months. If the symptoms persist, you’ll likely need further treatment, with your doctor recommending one of the following non-surgical treatments:
- Nitrate Ointment: Applied externally, nitrate ointments help heal by increasing blood flow to the fissure, reducing swelling around the area, and decreasing pricking, tingling sensations, and discomfort. This is the medical treatment of choice when other conservative measures fail. Side effects may include headaches, which can be severe at times.
- Topical anaesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
- Botulinum toxin type A (Botox) injection is administered to paralyze the anal sphincter muscle and ease the spasms.
- Blood pressure medications can help relax the anal sphincter. They are given orally or applied externally, especially when the nitrate cream is not effective.
Surgery is the last resort when the fissure is chronic, and any of the conservative & non-surgical treatments mentioned above are ineffective. Surgery is also recommended in cases where the symptoms are severe.
- Chemical Sphincterotomy: It is a relatively painless, non-operative procedure where medicinal doses are used to cure fissures.
- Internal Sphincterotomy: This procedure is required for treating chronic anal fissures when other options fail. As the name suggests, a portion of the anal sphincter muscle is surgically removed, resulting in fewer and less severe spasms.
- Fissurectomy: This surgical procedure is rare and can be used for children. It involves the removal of the edges of the fissure.
- Pilonidal Sinus: A Pilonidal Sinus is an abnormal packet in the skin that develops over the tailbone and usually contains hair and skin debris. Commonly found in men, characterized by painful swelling that exudes pus and blood. With the advent of Laser Pilonidoplasty and the hope of a faster recovery, encouraging patients to opt for this procedure.
- Rectal Prolapse: It is a rare condition in which the rectum – the last few inches of the large intestine drops down and slides out through the anal opening. Depending on the severity, treatment options include:
- STARR surgery
- Thiersch procedure
Healing & Recovery
It is important to note that complete healing with medical and surgical treatments can take approximately 6-12 weeks. The acute pain after surgery often disappears within a few days. Most patients will be able to return to a normal life schedule and resume daily activities a few short days after the surgery.
Anal fissures can be agonizing, troublesome, and highly distressing. At Vitality’s Laser Piles Clinic, Hyderabad, we offer laser treatment for anal fissures that heals the fissure completely and prevents it from recurring in the future. This procedure is perfect for people worried about complex surgeries, and we can do the surgery quickly without causing any pain. Our highly trained and experienced doctors with state-of-the-art technology will help you get rid of your condition perfectly. So, if you are looking for the best treatment of the fissures and leading a comfortable life, book an appointment today!