Anal fissure is one of the commonest causes of painful defecation. Most heal with conservative measures.
What is it?
A small tear in the lining of the anal canal causing severe pain on passing stool and sometimes bright red bleeding.
Conservative treatment
High-fibre diet, plenty of water, warm sitz baths, topical glyceryl trinitrate or diltiazem ointment for 6–8 weeks.
When surgery is needed
Chronic fissure resistant to medical therapy.
Surgical options
Lateral internal sphincterotomy (gold standard) or botulinum toxin injection. Day-care procedures with excellent outcome.
Prevention of recurrence
Maintain fibre and fluid intake; avoid straining.
Frequently Asked Questions
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