Fissure in ano

Diagnosis

Per rectal examination is painful due to Spasm of internal sphincter, A split or cut on the posterior or anterior  midline of the anal verge.

Type

Acute fissure (Less than 6 weeks), superficial with sharply demarcated edges Chronic fissure (More than 6 weeks) , usually deeper and may have secondary features including hardening of edge of the fissure, a sentinale pile which looks like small skin tag and hypertrophied anal papillae.

Treatment

Acute anal fissure – May be cured by regulating dietary habits, exercise, medicines etc. Chronic fissure-It is treated by the world's latest treatement i.e. lateral subcutaneous internal sphinctorotomy(by RF) is the best procedure done under short GA or Local Anaesthetia, after which the patient may be discharged within 24 hrs.

Benefits

No dressing , No bedrest, Office procedure, Immediate relief in pain and burning. The patient does not realize that he is cured while he is cured.

What is Fissure in ano

It is a condition characterized by a longitudinal crack or slit (ulcer) in the skin of anus. Fissure in ano is observed in children as well as in adults however it is more common amongst middle aged adults, The Posterior midline of the anus is the most common location for Fissure due to low blood supply in this area.

Symptoms of Fissure

Pain while passing stool Sharp agonizing knife like pain start when the individual passes stool. The pain may be severe and may persist for an hour or so It ceases suddenly If a Fissure become chronic (longstanding) and deep another kind of pain can develop It is a dull ache in the anus and pelvis that starts a few minutes after the bowel movement and can persist for hours after passing stools, this pain is due to spasm of the internal sphincture muscle and can be quite debilitating. Blood streaked stool (typically on the side of the stool, which is bright red in color) Discharge, swelling and itching occur especially with chronic Fissure.

Causes

Most common cause is CONSTIPATION. Chronic constipation due to any reason ( such as habitual drug induced, irregular meals or irregular bowel habits) leads to recurring abrasion or forcefully rubbing of the ANAL MUCOSA which leads to Fissure Other causes-Chronic diarrhea, Multiple pregencies, chronic use of laxative Incorrectly performing operations for piles.

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