Pediatric Surgery for Anal Fissure
An anal fissure, fissure in Ano or rectal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet. What is an anal fissure?An anal fissure is a tear in the lining of the lower rectum (anal canal) that causes pain during bowel movements. Anal fissures don't lead to. Apr 08, · An anal fissure, although ostensibly a minor problem, may lead to years of discomfort if not promptly diagnosed. Too often, the problem remains.
Abdelnaby A, Downs JM. The overlying incision is closed. What causes constipation, chronic constipation, and severe constipation? The cost of a unit vial of toxin is several hundred dollars and unused toxin cannot be saved. Initial treatments for anal fissures that are often very successful are designed to make the stool softer, easier to pass, and prevent constipation.
What is an anal fissure?
An anal fissure is a tear in the lining of the lower rectum anal canal that causes pain during bowel movements. Anal fissures don't lead to more serious problems. Most anal fissures heal with home treatment after a few days or weeks.
These are called short-term acute anal fissures. If you have an anal fissure that hasn't healed after 8 to 12 weeks, it is considered a long-term chronic fissure. A chronic fissure may need medical treatment.
Anal fissures are a common problem. They affect people of all ages, especially young and otherwise healthy people. Fissures can also be caused by a rectal exam , anal intercourse, or a foreign object.
In some cases, a fissure may be caused by Crohn's disease. Many experts believe that extra tension in the two muscular rings sphincters controlling the anus may be a cause of fissures. The outer anal sphincter is under your conscious control. But the inner sphincter is not. This muscle is under pressure, or tension, all of the time. If the pressure increases too much, it can cause spasm and reduce blood flow to the anus, leading to a fissure.
This pressure can also keep a fissure from healing. Sometimes an anal fissure may be a painless wound that won't heal. It may bleed from time to time but cause no other symptoms.
A doctor can diagnose an anal fissure based on your symptoms and a physical exam. The exam may include:. The doctor may wait until the fissure has started to heal before doing a rectal exam or anoscopy. If an exam needs to be done right away, medicine can be used to numb the area. During an exam, a doctor can also find out whether another condition may be causing the fissure. Having several fissures or having one or more in an area of the anus where fissures usually don't occur can be a sign of a more serious problem, such as inflammatory bowel disease or a weakened immune system.
Most short-term anal fissures can heal with home treatment in 4 to 6 weeks. Pain during bowel movements usually goes away within a couple of days after the start of home treatment. Don't avoid having bowel movements. Knowing that it might hurt may make you anxious. But trying not to have bowel movements will only make constipation worse and keep the fissure open and painful. About 9 out of 10 short-term fissures heal with home treatment-including using stool softeners or fiber supplements and taking regular sitz baths.
And about 4 out of 10 long-term anal fissures will heal after home treatment is used. But not all fissures will heal with just home treatment. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include nitroglycerin cream, high blood pressure medicines in pill or gel form, or injections of botulinum toxin Botox. If medicines don't stop your symptoms, you may need to consider surgery. The most commonly used surgery is lateral internal sphincterotomy.
In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure. What is an anal fissure? What causes an anal fissure? Anal fissures are caused by injury or trauma to the anal canal. Injury can happen when: You pass a large stool. You are constipated and try to pass a hard stool. You have repeated diarrhea.
Childbirth can cause trauma to the anal canal. What are the symptoms? A sharp, stinging, or burning pain during bowel movements. Pain from a fissure may be quite severe.
It can be brief or last for several hours after a bowel movement. You may see a small spot of bright red blood on toilet tissue or a few drops in the toilet bowl. The blood from a fissure is separate from the stool. Very dark, tarry stools or dark red blood mixed with stool may be a sign of a more serious problem. Tell your doctor if you have any bleeding with a bowel movement. Continued How is an anal fissure diagnosed?
The exam may include: Looking at the fissure by gently separating the buttocks. A digital rectal exam. The doctor inserts a gloved finger into the anal canal. This involves using a short, lighted scope to look into the anal canal. How is it treated?
There are several steps you can take to relieve your symptoms and help the fissure heal: Try to prevent constipation. Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber. Drink plenty of fluids. Get some exercise every day. Take a fiber supplement, such as Citrucel or Metamucil , every day if needed.
Read and follow all instructions on the label. Schedule time each day for a bowel movement. Try taking stool softeners or laxatives to make bowel movements less painful.
Ask your doctor how long you should take laxatives. Sit in a tub filled with a few inches of warm water for 20 minutes, 2 or 3 times a day.
This is called a sitz bath. It soothes the torn tissue and helps relax the internal anal sphincter. These may help soothe anal tissues. But fiber and sitz baths help symptoms more. Continued What happens if the fissure doesn't heal on its own?
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