Anal Fissure Treatment in Indore

Anal Fissure – Description

An anal fissure is a small tear or crack in the lining of the anus, which may cause pain, bleeding, and discomfort with bowel movements. It is usually caused by passing hard or large stools, chronic constipation, or straining during bowel movements. Anal fissures can also be associated with childbirth, inflammatory bowel disease, or chronic diarrhoea.

Common symptoms include:

Severe pain while defecating and afterwards

Bright red blood on the stool or toilet paper

Itching or irritation around the anus

A visible tear or crack near the opening of the anus

Spasms of the anal sphincter, causing more pain

Fissures are classified as acute (recent onset) or chronic (lasting more than 6–8 weeks).

Types of Anal Fissures

1. Acute Anal Fissures

Acute onset; usually due to passing a hard stool

Pain can be severe but often resolves itself without further treatment within a few weeks.

2. Chronic Anal Fissures

Persist for more than 6–8 weeks

Often develops raised edges with a sentinel skin tag

May be associated with anal sphincter spasm and require more aggressive treatment

3. Location

Most fissures occur in the posterior midline of the anus (back), sometimes anteriorly

Less common fissures located outside these areas can be indicative of other conditions, such as Crohn's disease or infection.

Treatment of Anal Fissures

1. Conservative / Non-Surgical Measures

High-fibre diet: fruits, vegetables, whole grains to soften stool

Hydration: Adequate intake of water to avoid constipation

Stool softeners or bulk-forming laxatives

Sitz baths: soaking in warm water several times a day to relax the anal muscles

Topical creams:

Nitrates (such as nitroglycerin ointment) to relax sphincter muscles

Calcium channel blockers (e.g., diltiazem cream)

Local anaesthetics for alleviating pain

2. Medications

Analgesics: Paracetamol or NSAIDs

Botulinum toxin (Botox) injections: relax the anal sphincter in chronic cases

3. Surgical Treatment

Lateral internal sphincterotomy: a small cut is made in the anal sphincter to lessen spasm and allow healing

Usually reserved for chronic fissures that are not responding to conservative treatment.

Prevention of Anal Fissures

1. Prevent Constipation

High-fiber diet

Adequate hydration

Avoid sitting on the toilet for extended periods of time

2. Healthy Bowel Habits

Answer the call of nature without delay

Avoid straining during bowel movements

3. Manage Diarrhoea

Treat the infection or dietary cause promptly to reduce irritation.

4. Anal Hygiene

Gentle cleaning, so as not to irritate. Avoid rough soaps or vigorous wiping 5. Regular Exercise Improves bowel motility and reduces constipation