Fissure
R S Care
Anal Fissure Treatment
Immediate treatment for anal fissures is essential as it could become a chronic condition. You can avail the best-in-class treatment for anal fissures at R S Care, as we are equipped with cutting-edge laser surgery, anorectal specialists, and medical care coordinators at no-cost EMIs.
Treatment of Fissure
MEDICINES
Acute fissures ( < 6weeks old ) are usually treated non-surgically with medicines. Even Chronic fissures are first given a trial of medical management. The aim of the treatment is to break the vicious cycle of anal sphincter spasm and tearing of the anal skin.
I. MCDPA
- Medicines – Herbal medicines to reduce inflammation in the area
- Constac -Taken before bedtime to add bulk and soften the stools.
- Diet – A fibre rich diet to prevent constipation. An increase in the water and fluid intake also helps
- Physiotherapy – Pelvic floor physiotherapy helps to reduce spasm of the anal sphincter.
- Ayurveda therapy – Medicated herbal oils are used.
II. Sitz bath
Sitting in warm water that covers your hips and buttocks after a bowel movement helps to reduce the post defecation discomfort.
III. Nitroglycerin / Glyceryl trinitrate
Used in the form of an ointment, it helps to reduce spasm of the anal sphincter. However, it has side effects like headache, light-headedness which limit its role.
IV. Nifedipine ointment
It is also used to relax the anal sphincter.
SURGICAL TREATMENT
Acute fissures which do not heal with conservative therapy and most of the Chronic fissures need a surgical line of treatment.
I. Botulinum A toxin ( Botox ) injection
The Botox is injected into the internal anal sphincter to relax it. The effects of the Botox last for 3 months by which it is hoped that the fissure would heal. However, the high cost of therapy, and a major side effect in the form of varying degrees of incontinence limit the use of Botox.
II. Lords dilatation
This is an age old treatment which provides good sphincter relaxation and relief from pain. However, the forceful dilatation can lead to multiple abrasions on the anal skin and may need 6-12 weeks to heal. Also, the scarred tissue over the fissure could be a source of constant discomfort and needs to be removed separately.
III. PLIS ( Partial Lateral Internal Sphincterotomy )
Done under general anaesthesia, this is a minimally invasive procedure in which a small cut is made in the internal sphincter. Thus straining during defecation is considerably reduced and there is satisfactory relief from pain. This procedures requires a good amount of skill and expertise on the part of the surgeon as an inadvertent excessive cutting of the sphincter may lead to incontinence.
IV. Laser surgery
The laser is used to perform internal sphincterotomy. This procedure is almost bloodless and the surgeon has good control over the operation site. Additionally, the chronic fibrosed scar is debrided with the laser. This prevents any long term discomfort and enables a quicker recovery.
V. BOTOX For Fissure
Botulinum Toxin A popularly known by brand name Botox is a neurotoxic protein that produces temporary, localized, flaccid paralysis of muscle. It is used commercially in medicine, cosmetics and research. It is often used to treat Anal Fissure, as an alternative to surgery, especially when medicines have been tried without success.
What are the Benefits of Laser Anal Fissure Surgery?
Here are some benefits of laser anal fissure surgery –
- Minimally invasive: Laser anal fissure surgery is a minimally invasive procedure that results in less pain and discomfort compared to traditional surgery.
- Outpatient procedure: The procedure is performed on an outpatient basis, allowing patients to return home the same day.
- Fewer complications: Anal fissure laser surgery has a lower risk of complications such as bleeding and infection compared to traditional surgery.
- Short recovery period: The recovery time for anal fissure laser surgery is typically shorter, with patients able to resume normal activities faster.
- Most Effective: Fissure laser surgery is the most effective option for chronic anal fissure treatment that has not responded to other conservative methods.
- High success rate: Fissure laser surgery offers a higher success rate than traditional surgery in preventing fissure recurrence.
- Less pain: The laser seals the nerve endings, resulting in less post-operative pain and discomfort.
- Low risk of anesthesia: The procedure can be performed under local anesthesia, reducing the risks associated with general anesthesia.
- Less scarring: Fissure laser surgery results in minimal scarring, with the incision made by the laser being smaller and more precise.
- Fewer side effects: The procedure is safe, with minimal side effects and a low risk of complications.
