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Specialities

Fissure in Ano

What is Fissure in Ano?

An Anal Fissure in Ano is small oval shaped tear in skin that lines the opening of anus.

Causes of Fissure:

  • Hard Stool
  • Faulty Dietary Habits
  • Diarrhea
  • Childbirth
  • Anal sex

Signs & Symptoms:

  • Painful Defecation
  • Bleeding
  • Pruritus Ani
  • Sentinel Pile

Diagnosis of Fissure:

  • Digital examination
  • External examination
  • Proctoscopy

Medicines

Acute fissures are usually treated non-surgical with medicines. Even chronic fissures are first of medical management. The aim of the treatment is to break the vicious cycle of anal sphincter and tearing of the anal skin.

  • Medicines - Herbal medicines to reduce inflammation in the area.
  • Stool Softener -Taken before bedtime to add bulk and soften the stools.
  • Diet - A fiber rich diet to prevent constipation along with an increase in the water and fluid intake also helps.
  • Physiotherapy - Pelvis floor physiotherapy helps to reduce spasm of the anal sphincter.
  • Ayurveda Therapy - Medicated herbal oils are used.
  • Sitz Bath - Sitting in warm water that covers your hips and buttocks after a bowel movement helps to reduce the post defection discomfort.
  • Nifedipine Ointment - Used to relax the anal sphincter

Surgical Treatment available at Shree Hospital for Fissure in Ano:

Acute Fissures which do not heal with conservative therapy along with most other Chronic Fissures need a surgical line of treatment.

  • Lords Dilatation - This is an age old treatment which provides good sphincter relaxation and relief from pain. However, the forceful dilatation can lead to multiple abrasions on the anal skin and may need 6-12 weeks to heal. Also, the scarred tissue over the fissure could be a source of constant discomfort and needs to be removed separately.
  • PLIS (Partial Lateral Internal Sphincterotomy) - Done under general anesthesia, this is a minimally invasive procedure in which a small cut is made in the internal sphincter. Thus, straining during defecation is considerably reduced and there is satisfactory relief from pain. This procedure requires a good amount of skill and expertise on the part of the surgeon as an inadvertent excessive cutting of the sphincter may lead to incontinence.
  • Laser Surgery - The laser is used to perform internal sphincterotomy. This procedure is almost bloodless. Additionally, the chronic fibroses scar is debrided with the laser. This prevents any long term discomfort and enables a quicker recovery.