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anal fissure

What is anal fissure?

Anal fissure is a small tear in the skin lining the anus. It is a fairly common condition, however, often confused with other conditions that can cause anal pain and bleeding, such as hemorrhoids. Its typical symptoms include pain during and/or after defecation and bleeding. It is not uncommon for patients to try to avoid going to the toilet because of the intense pain they experience.
Anal fissures normally have atraumatic origin, being caused by anything that can tear or irritate the skin lining the anal canal. The most typical cause is constipation. They can be acute or chronic and recurrent; the latter are sometimes associated with a small nodule called a sentinel polyp.

The treatment of anal fissure

anal fissure, fiber, dietary fiberIn many cases, simply treating the constipation yes Can achieve healing of the fissure. Treatment of acute fissures in almost 90% of cases is medical: a diet rich in fruits and vegetables, taking supplements high-fiber pharmacological drugs, of special lubricants and liquids, along with appropriate activity physical, help treat constipation, promote motility bowel and promote healing of the fissure. Baths in warm water, lasting 10-15 minutes and repeated several times a day, promote relaxation of the muscles anal and contribute to wound healing. Appropriate local therapy, also known as chemical sphincterotomy and prescribed from time to time by the proctologic surgeon depending on the characteristics of each individual patient, completes the picture of medical treatment Of anal fissure. In recent years, the use of BoTox also injected at the level of the sphincter area led to excellent results.

Can anal fissure recur?

Unfortunately, the fissures recur frequently, and it is usually always the constipation the main cause. Therefore, once the fissure is healed and the pain is gone, the effort must be aimed at keeping the stool soft and well lubricated, taking in adequate amounts of fruits, vegetables, and fluids with the diet and, if necessary, continuing to use dietary fiber supplements.

What to do if anal fissure does not heal?

In these cases, a proctological examination is mandatory. The presence of conditions that could give the same symptom picture as anal fissure, such as inflammatory bowel disease(ulcerative colitis, Crohn's disease) or tumors of the anus, should be discarded. Once the absence of such conditions is assured, patients with anal fissures that do not go to healing should be given theindication forsurgery surgery of anal sphincterotomy.

The surgery for anal fissure

anal fissure, anal sphincterotomy, SLISurgical treatment of anal fissure consists of. internal lateral sphincterotomy (SLI), which is in the incision of a small part of the internal sphincter muscle of the anus. It is an intervention that is generally well liked by the patient, who sees his pain disappear overnight, as normal postoperative pain is absolutely negligible compared to the suffering inflicted up to that point by the fissure. Surgery may be followed, in a very small percentage of cases, by a Modest incontinence to gases and, much more rarely, to feces, which normally disappear as the surgical wound heals.

 

PER SAPERNE DI PIÙ…
  • Anal fissure - By Patient.info, a leading English-language site for patient communication and education.. Very well covered sections on medical therapy.
  • Anal fissure– Curata dalla Mayo Clinic, accuratissima e chiarissima revisione per il paziente. In inglese.
  • La ragade analeDocumentodella Società Italiana di Chirurgia Colo-Rettale.
  • Ragade analeFoglietto informativo preparato dall’équipe di Cuccomarino,MDper i propri pazienti

 

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