ANAL FISSURES

Anal fissure typically occur after the passage of a hard constipated motion. It sometimes is associated with other pathological processes in the colon.

Like other small tears in the body an anal fissure may heal by itself within 14 – 21 days.

During this period a patient should:

•  Increase the fibre in their diet
• Increase the oral fluid intake
• Not delay a bowel movement when urge to defecates occurs
• Apply topical ointments including a local anesthetic ointment and / or glycerol trinitrate preparation
• Sit in a warm sitz bath 2 – 3 times/day
• Oral analgesia may be required

If inspite of the above no improvement has been achieved, then other interventions may have to be considered. 

This includes amongst others:

• Internal Sphincterotomy
• Botulinum toxin injection

Laser Therapy has been successfully incorporated as a treatment modality for selective anal fissures.

Recovery following surgery largely consists of an extended period of the conservative treatment described above. However relief from symptoms dissipate largely instantaneously. Patient can go home on the same day of surgery or the following day. Resumption of work is typically achieved within 48 hours of surgery.