Have you experienced a sharp anal pain like as though you’re passing glass or razor blades during bowel movements, which make your life a living hell? Occasionally, you may also notice some fresh blood after a session of bowel movement.

If so, it’s likely to be an Anal Fissure.

What are we talking about?

When the lining of the anal canal develops a tear or a sore, it is called an anal fissure. The anal canal is the last part of the rectum before the anus. Fissures can occur in just about anyone, but are more common in middle aged or young adults. A fissure can be difficult to heal because it causes a spasm in the anal sphincter and aggravates itself, creating a vicious cycle of pain and irritation.

This is a chronic problem and patient may not be able to achieve any relief from the continuous pain, anal discomfort and fresh bleeding.

Normal Protocol and Strategy of Treatment

  • First and foremost it is important to discuss the problem with your doctor which is then followed by an examination. A diagnose is formulated.
  • Post diagnosis, treatment options are put forth, conservative methods include application of topical creams (they are effective but don’t treat the original problem, i.e., the spasm of circular muscle)
  • Botox injections (painless injection to sphincter muscle which doesn’t last longer than 10 minutes and relaxes the spasms. The anal fissure can heal on its own.) Botox has a temporary effect lasts for 4-6 month and it could be repeated as per requirement. This approach is relatively new and effective and is fast spreading all over the world.
  • If both previous methods fail, then we have the right surgical solution, latheralsphincterotomy. It involves destroying, irreversibly, a part of internal circular sphincter muscle. This may lead to two well defined side effects, i.e., fecal incontinency and uncontrolled flatus apart from other possible complications.

Compared to previously mentioned methods, latheralsphincterotomy has serious side effects which are irreversible.

For fresh and newly diagnosed anal fissure, Conservative treatment either Cream or Botox injection would be advisable and appropriate.

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