Anal Fissure
A small tear in the lining of the anus causing pain and bleeding during bowel movements.
Overview
An anal fissure is a small tear in the lining of the anal canal, causing severe pain during defecation and bleeding. Acute fissures heal within 6-8 weeks with conservative treatment. Chronic fissures (>6 weeks) often require intervention due to internal sphincter spasm preventing healing.
Causes
- Passage of hard, large stools
- Chronic constipation
- Chronic diarrhea
- Childbirth trauma
- Crohn's disease
- Anal intercourse
- Reduced blood flow to the anal area
Risk Factors
- Constipation
- Low-fiber diet
- Dehydration
- Pregnancy and postpartum period
- Inflammatory bowel disease
- Age (common in infants and young adults)
Symptoms
Diagnosis
- Visual inspection of the anal area
- Digital rectal examination (often deferred due to pain)
- Anoscopy (after pain subsides or under anesthesia)
- Differentiate from: hemorrhoids, perianal abscess, fistula, cancer
Treatment Options
Surgical Treatment
Lateral Internal Sphincterotomy (LIS) is the gold standard for chronic anal fissures that fail medical therapy. A small portion of the internal sphincter is divided, reducing spasm and allowing the fissure to heal. Success rate exceeds 95%. Dr. Bhagat performs this as a day-care procedure.
Recovery
LIS: Day-care procedure, go home same day. Pain improves dramatically within 24-48 hours. Complete healing in 4-6 weeks. Warm sitz baths and stool softeners continued for 2-3 weeks post-operatively.
Prevention
- High-fiber diet (25-30g daily)
- Drink adequate water (8-10 glasses)
- Don't delay bowel movements
- Avoid straining
- Regular exercise
- Sitz baths during flare-ups
Frequently Asked Questions
Will an anal fissure heal on its own?
Is fissure surgery painful?
Expert Consultation Available
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