Which specialist performs the treatment of anal fissure? (2023)

Fisura analIt is a deterioration of the wall of the anus. It usually doesn't come with many medical complications. However, it needs to be treated urgently as it can make your life very uncomfortable.

anal fissure symptoms

An anal fissure is associated with a number of symptoms. Since some of these are similar to other health conditions, it is advisable to see your doctor for a proper diagnosis. These are the symptoms of an anal fissure:

• presence of blood in the stool
• Pain after a bowel movement for a period of time
• Itching or irritation in the anal area
• A real cut in her anus
• A burning sensation when having a bowel movement.

Types of Anal Fissures

• Generally–It is possible to have an acute or chronic anal fissure. They are classified as primary or secondary depending on whether the trigger is known or unknown.

• Acute and chronic anal fissure -Acute anal fissures are associated with a lot of pain when going to the toilet. They are not easy to see as they are usually superficial although they take time to heal. Acute or short-lived anal fissures typically take 4 to 6 weeks to heal at home. Meanwhile, chronic anal fissures generally cause less pain than acute anal fissures. However, chronic anal fissures form ulcers as they get deeper, taking more than 6 weeks to heal or not healing at all. Internal anal sphincter spasms prevent a good blood supply to the fissure and hinder the healing process. The ulcer that doesn't heal can become infected with fecal bacteria.

• Primary and secondary anal fissure -The primary anal fissure is usually located in the posterior anal midline, although a small percentage is located in the anterior midline. In most cases, it is not known what triggers the primary anal fissure. Secondary anal fissures, in turn, result fromInflammatory bowel disease, previous surgeries or infectious diseases such as STDs. Herpes, tuberculosis, cytomegalovirus, chlamydia, and HIV are infections commonly associated with a secondary anal fissure.

Diagnose

• The diagnosis is often made based on pain or bleeding with a bowel movement. A specialist can usually identify an anal fissure simply by running a few tests or reviewing the patient's medical history.
• During a rectal exam, a gloved finger is inserted into the anal canal. However, it is rarely performed on a patient because it is too painful. Instead, a visual examination using an anoscope is performed.
• A sample of rectal tissue is taken for diagnosis if the fissure is not visible.
• No further testing is needed unless the symptoms suggest an underlying bowel disorder or the doctor wants to rule out other disorders. Some of these additional tests are colonoscopy,Sigmoidoscopy flexibleand anal manometry.

What to expect from your doctor

Here are some of the questions to expect from your doctor:

• Where are the symptoms most noticeable?
• Are the symptoms severe and if so, how severe?
• Is there anything that seems to improve your symptoms?
• When did you start feeling the symptoms?
• Have you experienced the symptoms frequently?
• What seems to make symptoms worse?
• For example, do you have other illnesses?Crohn's disease?
• Are your bowel movements hard?

Treatment

Treatment can be divided into several types:

• Generally -Some anal fissures do not require treatment and will heal on their own in a few weeks. But if necessary, home treatments come first. In some cases, non-surgical treatments can be used to reduce pain and facilitate healing, and surgical procedures can be performed as needed, i.e. when the fissure is unresponsive to treatment and develops into a chronic anal fissure.
• for babies-It is recommended to stay hydrated and change diapers frequently.
• home care methods-These treatments are particularly applicable to acute anal fissures:

1. Get regular exercise for at least 30 minutes every day.
2. Vaseline applied to the anal opening
3. Lots of fluid intake
4. gentle cleaning
5. Use of a stool softener
6. Avoid straining during a bowel movement
7. Using fiber supplements in your diet.
8. Using Sitz Baths: A sitz bath involves sitting in very warm water for at least 15 to 20 minutes each day.
9. Increase the fiber content in your diet, for example by eating nuts, vegetables, fruits, grains, beans and psyllium, a fiber supplement.

A. Non-surgical Treatments (Medications)

• These treatments are used to relieve muscle pain in the affected area. These include numbing creams or muscle pain relievers. They are for external use around the wound.
• Anesthetic creams include calcium channel blockers, zinc oxide, and topical nitroglycerin. Nitroglycerin creams improve blood flow to the wound and allow it to heal. However, although nitroglycerin has this benefit, it does come with some complications, for exampleHeadache,dizzinessand low blood pressure. Therefore, it is recommended to apply the cream either lying down or sitting down. Men should avoid using nitroglycerin within 24 hours of taking erectile dysfunction medication, as the combination could lower blood pressure significantly.

B. Surgery

Surgery is considered if the fissure is taking too long to heal. Treatment for surgery includes internal lateralssphincterotomyor anal stretching. The main goal of this surgery is to remove the sphincter spasm and allow normal blood flow to the area.

1. Lateral Internal Sphincterotomy (LIS) -This is for patients under general anesthesia and is usually a same day surgery. In lateral internal sphincterotomy, the internal anal sphincter is divided slightly, allowing blood supply and relaxing the sphincter. This procedure generally has a high success rate, but it can involve some complications, such as: B. slow healing of the incision or sphincter and postoperative pain. The lateral internal sphincter usually takes about a week to heal.
2. anal dilatation -This is anal canal dilation and is performed less frequently than LIS. natural gas andfecal incontinenceare the complications involved.
3. skin flap coverage -This is the treatment used to treat anal fissures by using a skin flap to cover the fissure. This procedure has fewer complications and therefore attracts more and more patients.

Other less popular surgical treatments include:

- Tailored Anal Sphincterotomy - The sphincter is preserved better here than with the lateral sphincterotomy.

- Fissurectomy – This involves removing the anal fissure.

- Anal advance flap: consists in replacing damaged tissue with good tissue.

The colorectal surgeon: The specialist who performs anal fissure surgery

A colon surgeon is also known as a proctologist. This specialist is a renowned surgeon with training in the treatment and diagnosis of diseases of the colon, anus and rectum. Diseases of the colon and rectum require well-trained and experienced surgeons for the surgical and non-surgical treatment of both types of diseases. These surgeons perform routine colon exams, treat benign and malignant conditions, and of course, perform colon and rectal surgeries when needed.

A colorectal surgeon will perform or order the procedures necessary to make a diagnosis after evaluating the following symptoms:

• Darmincontinentz
• Fisura anal
• pain in the anus
• Anal warts and fistulas or other anal abscesses

See your doctor if you have any of the symptoms above.