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Anal Fissure

Fissure

​Fissure in Ano

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​​​​​​An anal fissure (fissure-in-ano) is a small, tear in skin that lines the opening of the anus.  Fissures typically cause severe pain and bleeding with bowel movements.  Fissures are quite common in the general population but are often confused with other causes of pain and bleeding, such as haemorrhoids.
An anal fissure can occur at any age and have equal gender distribution.  
​Patients get severe anal pain. It is more pronounced after the bowel movement. It may last for a significant time.  Many patients get such a severe pain that they differ going to the washroom as much as possible.

The patient often notices bright red blood on the toilet paper or a red streak on the hard stool.

Patient with long-standing fissure is often relatively symptom-free in between the washroom time.

Clinical examination by the surgeon offers the best method of diagnosis.

Treatment 

The majority of chronic anal fissure patients do not require surgery. Stool softeners and increased water intake may be necessary to promote soft bowel movements.  pain relief which in turn helps the healing process.  Topical anaesthetics jelly can be used for anal pain. Warm tub baths (sitz baths) for 10-20 minutes (especially after bowel movements) are soothing and promote relaxation of the anal muscles. Some patients with severe pain due to acute fissure may require Minor surgical procedure. Anal Dilatation or Internal sphincterotomy is the surgical options available in the indicated cases with very severe pain. Increase dietary fibres by having more of veg salad and fluids in every meal. Local application of anaesthetic jelly helps the majority of the patients. The precise method of application of jelly gives great pain relief. Even when the pain and bleeding have subsided, it is very important to continue the diet rich in the fibres. Carrot, Cucumber, Raddish, spinach are the rich source of the dietary fibres.

Further assessment may be necessary if the problem returns without the obvious reason like constipation or hard motion.

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Questions To Ask Your Doctor
Why am I having these symptoms? 
Should I make changes to my diet? 
Do I need any treatment? 
What should I do if these symptoms return?

Is it something more sinister? 

Occasionally, other conditions can cause similar symptoms.

Samarth Clinic
Above the Just Casual Showroom
Herekar park Building
Rajyog  B Wing 3  First Floor
Near Kamala Nehru Garden
Off Bhandarkar road
Pune 411004
Maharashtra
India
Deccan Gymkhana PO