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Advised anal fissure surgery. But it only facilitates the healing. Why can't I try healing it by medicines?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
Hi, I would like to know whether I should go for the Anal Fissure surgery. I have been advised for an anal fissure surgery since it is a chronic problem for me. From what I have read anal fissure surgery is known as LIS ( Pls correct if I am wrong) and I understand that this surgery does not actually heal the fissure and that it only facilitates the healing. Pls advise if this is true and in then in that case, should I go for the surgery or Is there any other way of medication / treatment through which Anal fissure can be treated and cured. I am suffering from the anal fissure related pains since last 15 years during which it has re-occurred many times and with some simple medication from the physician, pain was gone in a few days. From what is heard, fissure is a cut or bruise or damage at the annus. So why this cant be healed by simple medication or treatment just like a cut at any other part of the body, why does this require surgery ?
Posted Tue, 22 May 2012 in Chron's Disease
Answered by Dr. Ketan Vagholkar 25 minutes later
Anal fissure is an abrasion in the lining of the anal canal. It is extremely painful and causes spasm of the sphincter. It is this spasm which inhibits healing. Conservative methods do help like sitz baths, stool softeners and diltezam cream. But this may be temporary.

Surgery is performed to overcome the sphincter spasm which will allow healing of the lesion. Since you are on long-term analgesics it may be causing problems. I would suggest a 10 day trial of conservative treatment.

If this fails then consider surgery only after evaluation and comparison of the severity of spasm before starting treatment and after the course of treatment.
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