Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
153 Doctors are Online

Anal fissure - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3483 Questions
Doctor :   Hi
Doctor :  
How can I help you?
User :   Hi Dr
User :   I have anal fissure
Doctor :   Ok

User :   I am not sure whether to go for a surgery?
User :   Bcos most of the doctors suggest sphincterotomy
Doctor :  
Ok
Doctor :  
I shall explain you
User :   Is it the right decision to go for a (LIS)sphincterotomy surgery
User :   Ok
Doctor :   May I know your age?

User :   29
Doctor :   Ok

Doctor :  
Fissure is a break in the area
Doctor :  
mucosal line is broken
User :   Yes
Doctor :  
Do you know the underlying cause for it?
User :   I had a laser surgery for piles 5 years ago...
User :   since then my piles pbm is cured
Doctor :   Ok

User :   but whenever I have hard stool I experience pain
Doctor :   Ok

User :   sometimes it subsides aftera week...
User :   sometimes it disturbs for a month with bleeding..............
Doctor :   Ok

Doctor :   Fissure size and extent determines the need of any surgery

User :   Now I use xylocaine oin... before my bowel mov..
Doctor :  
and also the extent of apin
Doctor :  
You are using the right medication
User :   I consulted a doctor and he examinde and suggested surgery....
User :   I have been prescribed with antibiotic + paracetamol + xylocaine oinment
Doctor :   Ok

Doctor :  
that is fine
Doctor :  
Xylocaine is more important
User :   The pain has come down after using xylocaine....but it still bleeds
User :   Does it help it healing the fissure
Doctor :   It helps in relieving the pain

Doctor :  
the fissure should heal on its own
Doctor :  
you should support it with good diet, fiber supplement, sitz bath and xylocaine
User :   Are there chances of permanant cure with the current medication
User :   Or is it a temporary relief...
Doctor :   If it heals, then there is no problem

Doctor :   but till then there would be pain

Doctor :  
are you taking sitz bath?
User :   No..does it help it curing fissure or temp...relief from pain
Doctor :   It helps in improving the inflammation problem

Doctor :  
and hence it is beneficial
User :   Ok...And if i hav to go for surgery....
User :   I hav a query regarding the LIS (surgery)...I am concerned about the post operative pain
User :   Since I hav already undergone piles operation... and the post operative pain is terrible
Doctor :   Ok

Doctor :   I shall tell you
Doctor :   You have undergone a fairly advanced treatment
Doctor :  
as you said it was Laser assisted
Doctor :  
there is one more cryosurgery
Doctor :  
but those are for piles mainly
Doctor :   Since when are you having this problem?

Doctor :  
fissure, I mean
User :   since 3-4 years....only when I hav hard stool
User :   after the hard stool BM....for a week
Doctor :   Ok

Doctor :  
If you can control that
Doctor :  
you can wait to see if surgery is essential?
User :   Ok
User :   But I want to know that even advacned fissure is curable by medication???
User :   Is it possible
Doctor :   Sure

Doctor :  
Meaning if it heals, you can keep it under check
Doctor :  
but surgery would give you faster and permanent relief
User :   And If i have to go for LIS, is the post operative pain tolerable unlike piles operation(not laser, heamoratomy..)
User :   Or is post operative(LIS)mild?????
Doctor :   Yes, there would be pain for sometime

Doctor :  
but with sitz bath and medications it could be kept under control
User :   Is the pain like tolerable compared to fissure pain?
Doctor :   Yes, it would be quite tolerable

Doctor :  
and will disappear after a few weeks
User :   What do you suggest ....from my current condition...as I am able to tolerate the BM pain using xylocaine oinment....
User :   Should I go for a surery???
Doctor :   I would suggest the non surgical approach for 1 month

Doctor :  
and then if you are able to control it in this month then you can postpone it for now
User :   I hav overcome such conditions several times but it recurs.....
User :   How do I eliminate permannently...
Doctor :  
but if the pain is intolerable then go for it
User :   Since I am using the oinment with somes laxatives.. i m able to manage ....
Doctor :   Yes, that is right for now

User :   Not sure abt the condition wthout medication
Doctor :  
The options are there, it is for you to decide now
Doctor :  
medication is needed only for now
User :   Sorry to ask you the question again...
Doctor :  
later you can control with diet, sitz bath and laxatives
User :   Is all the operations done on anal area is more painful than other operations????????
Doctor :   No, that is not the case

User :   Particularly can you comapre LIS with other operations done on anal area (in terms of pain)
Doctor :   The same

Doctor :   but milder compared to piles
User :   CAn you explain please......?????????
Doctor :   Yes, I shall tell you

Doctor :  
In sphincterotomy, the sphincter is loosened with a cut in it
Doctor :  
whereas in hemorrhoids, the procedure is different where in the vein area
Doctor :  
has to be excised and reconstructed
Doctor :  
that is the difference
User :   Ok
User :   Will it be done using gen anaethe...or local an....?
Doctor :   Regional anesthesia


User :   Hello Dr
Doctor :   Hi
Doctor :  
Welcome back
User :   I an really anxiuos abt the pain after the operation...
Doctor :  
Ok
Doctor :  
You need not be worried much
Doctor :  
It can be taken care of
User :   And can this operation be carried out using general aneasthesi..rather than local as I know the latter is painful
Doctor :   Ha
Doctor :  
You are a bit too anxious about it
User :   Yes ..bcos of expereince
Doctor :   Speak to your doctor about it
Doctor :  
I shall tell you a trick
Doctor :  
Tell him that you are too sensitive to pain and there have been periods of fainting due to excessive pain
Doctor :  
Tell him that it had been diagnosed as Vasovagal shock
Doctor :  
Also tell that you have been trying to improve but still the problem exists
Doctor :  
local is always preferred so that anasthetic side effects can be minimised
User :   Ok
Doctor :   but in children general is used

Doctor :  
as their tolerance level is low
User :   And ...I have seen my brother after a piles operation(not laser)with sleepless night
Doctor :   Initial 2 weeks

User :   after operation....is it the case withthis operation too...........
User :   Ok
Doctor :   Patients usually resume normal activities after 1-2 weeks. Full recovery may take as long as 2 months.

User :   And I suppose the operation will be done on the side and not on the anal path right?
User :   As I do not have any skin tags built
User :   ...due to fissure
Doctor :   I shall tell you

Doctor :  
First, any skin tags associated with the fissure are removed
Doctor :   Then, an incision is carefully made on the anal sphincter.
Doctor :   This relaxes the sphincter and allows stretching, so that less strain is placed on the fissure.
User :   If there are no skin tags, the sutures will done on one of sides without disturbing the bowel movement right???
Doctor :   Just an incision is put and loosened
Doctor :  
thats it
Doctor :  
very minor procedure
User :   But painful:)
Doctor :   Done under anesthesia

User :   Ok
Doctor :   so you should not worry much

Doctor :  
tension increases the pain
Doctor :  
so calm yourself
Doctor :  
taking good deep breaths before operation and also regularly is quite helpful
User :   I am aware of the operative pain...which will be controlled thru anest....
Doctor :   Even post, it wont be that painful like piles

Doctor :  
this is different
User :   I am really concerned abt the post operative pain.....sorry for repeating my anxiety
Doctor :   thats ok , I can understand

Doctor :  
One thing you can confirm
Doctor :  
this is lesser compared to piles
Doctor :  
say 50%
User :   Really.....................:)
User :   Are you sure.....
Doctor :   Ys

User :   Please be honest...But I am glad to here this
Doctor :  
You can be happy with it, it is a fact
User :   I believe you ...thanks doctor....but I am sure you are not convincing for the sake..
Doctor :   No, this is minor one compared to piles

Doctor :  
also the more external it is more the pain
User :   So it would be more or less compared to the fissure pain right????
Doctor :  
and the internal ones have less pain
Doctor :  
Post op, yes
User :   What do you mean by internal Dr????
Doctor :  
almost equivalent
Doctor :   withing the body and outsie

Doctor :  
Piles is external as it is outside compared to sphincter
User :   Ok
Doctor :   Is there any thing else I can help you with?

User :   Thanks doctor ..I was only concerned abt the pain...which I have already discusse..
User :   Your good name please Dr
Doctor :   Wish you all the best for surgery
Doctor :  
Do tell me your pain level compared to it
Doctor :  
piles surgery I mean
Doctor :  
I am Dr.Bharath here
User :   How can I contact you again in this portal
Doctor :   contact me at YYYY@YYYY
Doctor :   When you come for chat
Doctor :  
you can ask for me
User :   Ok
Doctor :  
they shall redirect it to me
User :   Thanks doctor
User :   Bye
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor