Fissure
It is a common disease of the anus which occurs because of a tear in the the mucosa of the anal canal. In simpler words, it is an ulcer caused following passage of hard stools.
Complaints: Pain while and after passing stools which may last for 5 secs, half an hour or half a day. There may be bleeding which is in the form of drops or lined along the stool. There may also be an associated swelling felt per anus, which may be painful.
Diagnosis: It is based on patient complaint and examination finding. There may be anal spasm, palpable ulcer and occasional blood on the gloves.
Treatment: It can be treated medically when it presents early and may require surgical management when late or severe presentation.
FAQ's
It can be treated medically when it presents early. Medical treatment is effective in 90% of early fissures. Increased water intake, stool softeners and local creams (ointments) can be used. Surgical management is needed when the complaints persist for a long time or when medical treatment fails.
Lateral internal sphincterotomy, Fissurectomy with sphincterotomy or fissurectomy with anal advancement flap.
Eventually a fissure which is not treated may progress to a fistula.