ANAL FISSURES
It is a painful tear at the lower end of the anal canal.
Anal fissure typically occur after the passage of a hard constipated motion. It sometimes is associated with other pathological processes in the colon.
Like other small tears in the body an anal fissure may heal by itself within 14 – 21 days.
During this period a patient should:
Increase the fibre in their diet
Increase the oral fluid intake
Not delay a bowel movement when urge to defecates occurs
Apply topical ointments including a local anesthetic ointment and / or glycerol trinitrate preparation
Sit in a warm sitz bath 2 – 3 times/day
Oral analgesia may be required
If inspite of the above no improvement has been achieved, then other interventions may have to be considered.
This includes amongst others:
Internal Sphincterotomy
Botulinum toxin injection
Both the above can be done as a day procedure operation with excellent long term results.
Recovery following surgery largely consists of an extended period of the conservative treatment described above. However relief from symptoms dissipate largely instantaneously. Patient can go home on the same day of surgery or the following day. Resumption of work is typically achieved within 48 hours of surgery.
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