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Advanced Fissure Treatment Clinic Dedicated for Anorectal Procedures


Fissure treatment in India :

Fissures are often confused with Piles. Anal Fissures are Linear Tears caused in the lining of the anus due to Trauma or injury, which causes the stretching of the Mucosa of the Anal canal. Fissures resemble a paper cut.

There are two types of Fissures :

  • Acute Anal fissures which have a sudden onset and don’t last longer than 6 weeks. They are very common and usually heal on their own with self-care.
  • Chronic ones last longer than 6 weeks, may need medicine or surgery to help them heal.

The can either in the Anterior (12 O’clock) or Posterior (6 O’clock) areas the Anal opening

Causes of Fissure :

The most common cause is spasming of the internal anal sphincter muscle which results in impaired blood supply to the anal mucosa. The result is a non-healing ulcer, which may become infected by fecal bacteria. Fissures look much like a paper cut. Fissures may be caused by

  • Prolonged diarrhea
  • Constipation
  • Childbirth trauma in women
  • Crohn’s disease
  • Anal sex
  • Poor toileting

Symptoms of Fissure :

Signs and symptoms of an anal fissure include:

  • Pain during bowel movements
  • Pain after bowel movements lasting up to several hours
  • Bright red blood on the stool or toilet paper after a bowel movement
  • Itching or irritation around the anus
  • A visible crack in the skin around the anus
  • A small lump or skin tag on the skin near the anal fissure

Treatment Options for Fissure :

Chemical Sphincterotomy (a non-operative painless technique using Injection Botox)

Chemical Sphincterotomy uses botulinum toxin (BOTOX injection) therapy for acute and chronic anal fissures. The toxin is injected directly into the internal anal sphincter (the circular internal muscles of the anal sphincter that controls the passage of feces). The most common cause for non-healing of anal fissure is spasming of the internal anal sphincter muscle which results in impaired blood supply to the anal mucosa. The injection prevents spasming and this effect lasts approximately three months until the nerve endings regenerate. This period allows the fissure to heal and the symptoms to resolve.

Closed Internal Sphincterotomy (Day Care Surgery)

Closed Internal Sphincterotomy is a surgical treatment for the chronic anal fissure. It is performed on the internal anal sphincter muscle (the circular internal muscles of the anal sphincter that controls the passage of feces). The internal anal sphincter is one of two muscles that comprise the anal sphincter. This surgical procedure lowers the resting pressure of the internal anal sphincter without destroying the effect of the sphincter. The internal anal sphincter is partially divided to reduce spasms. This improves the blood supply to the area and helps to heal the fissure.

This is done as a day care procedure. Internal Sphincterotomy (LIS) is recommended for its simplicity and its high rate of success (about 95%). The closed technique results in a smaller wound and is very effective.

References:
  Anal Fissures – Mayo Clinic
   https://www.mayoclinic.org/diseases-conditions/anal-fissure/symptoms-causes/syc-20351424
   Accessed on 22 September 2018

  Anal Fissures – Cleveland Clinic
   https://my.clevelandclinic.org/health/diseases/13177-anal-fissures
   Accessed on 23 September 2018

  Anal Fissure – University of Michigan
   http://www.med.umich.edu/1libr/Surgery/GenSurgery/AnalFissure.pdf
   Accessed on 23 September 2018