Description

What is Fissure in ano? A fissure in ano, also known as an anal fissure, is a small tear or ulcer that develops in the lining of the anal canal. It is a common condition that can cause significant discomfort and pain during bowel movements. What causes Fissure? Anal fissures are often caused by trauma or injury to the delicate lining of the anal canal. Common causes include passing hard or large stools, chronic constipation, diarrhea, childbirth, or anal intercourse What are the types of Fissure? Anal fissures can be classified into different types based on their characteristics and location. The classification helps in understanding the nature of the fissure and guiding appropriate treatment. Here are the types of fissures in ano: 1. Acute Fissure: Acute fissures are recent tears or ulcers in the lining of the anal canal. They typically develop as a result of trauma or injury to the area. Acute fissures are often associated with significant pain during bowel movements. 2. Chronic Fissure: Chronic fissures are long-standing fissures that persist for more than six weeks. They may result from an acute fissure that has not healed properly or from ongoing factors that contribute to the development of fissures, such as chronic constipation. Chronic fissures may have less severe pain compared to acute fissures but can still cause discomfort and lead to complications. 3. Recurrent Fissure: Recurrent fissures refer to cases where an individual experiences multiple episodes of fissures over time. These individuals may have a predisposition to developing fissures due to factors such as underlying conditions or anatomical abnormalities. 4. Posterior Midline Fissure: This type of fissure is located in the posterior midline of the anal canal. It is the most common type of anal fissure and often associated with constipation and passage of hard stools. 5. Anterior Fissure: Anterior fissures are located in the anterior midline of the anal canal. They are less common than posterior midline fissures but can also cause pain and discomfort during bowel movements. 6. Lateral Fissure: Lateral fissures occur on the sides of the anal canal. They are less common than midline fissures and may be associated with underlying conditions such as Crohn's disease or anorectal trauma. It's important to note that the classification of fissures helps in understanding their characteristics and guiding treatment decisions. However, the treatment approach may vary depending on individual factors, including the severity, duration, and underlying causes of the fissure. Consulting with a healthcare professional, such as a colorectal surgeon or proctologist, is crucial for an accurate diagnosis and appropriate management of an anal fissure. Why does a Fissure need treatment? The treatment of a fissure in ano aims to relieve symptoms, promote healing, and prevent recurrence. The initial approach for treating an anal fissure is usually conservative, focusing on lifestyle modifications and topical medications. Here are some common treatment options for fissure in ano: 1. Dietary and Lifestyle Modifications: Increasing dietary fiber intake, drinking plenty of fluids, and incorporating regular exercise can help soften the stool and prevent constipation, which can aggravate the fissure. These modifications can promote regular bowel movements and reduce the strain during defecation. 2. Stool Softeners: Stool softeners or laxatives may be recommended to help soften the stool and ease bowel movements. This can reduce the pressure on the anal canal and aid in healing. 3. Topical Medications: Over-the-counter or prescription topical medications can be used to relieve pain, reduce inflammation, and promote healing. These may include ointments or creams containing ingredients such as local anesthetics (e.g., lidocaine), nitroglycerin, or calcium channel blockers. 4. Sitz Baths: Sitz baths involve soaking the anal area in warm water for 10-15 minutes several times a day. This can help alleviate pain, reduce inflammation, and improve blood flow to the area, promoting healing. 5. Botulinum Toxin Injection: In cases where conservative measures fail to provide relief, a botulinum toxin injection may be considered. Botulinum toxin is injected into the anal sphincter muscle, causing temporary relaxation. This helps reduce spasm and pressure on the fissure, allowing it to heal. 6. Surgery: If conservative measures and other interventions are not successful, surgery may be required to treat a chronic or complex fissure. Surgical options include lateral internal sphincterotomy, where a small portion of the internal anal sphincter muscle is cut to relieve pressure, or fissurectomy, where the fissure is surgically removed.