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Multiple anal fissures, surgery, faktu, cremalax. Surgery a safe option ?

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General & Family Physician
Practicing since : 2010
Answered : 126 Questions
My wife has got multiple anal fissure (perhaps 3) doctor suggested surgery. is it safe? is it permanent? doctor denied for any piles/hammorhoid. she is currently using faktu & cremalax?
Posted Tue, 24 Apr 2012 in Digestion and Bowels
Answered by Dr. Tulasi Raman.P 49 minutes later

Thanks for writing your query to us.

Anal fissures are wound (crack or tear in the mucosal layer) in the tension area like the point edge in V. They are horribly painfull and it is difficult to pass stools or even gas for that matter. Piles and hemorrhoids are dilated and tortuous vein which can bleed fresh blood in the rectum-anus junction which may or may not be painful.

For anal fissure depending on the size, number and pain surgery might be suggested.

If small and can be tolerated then topical application of antiseptic cream may cure it but when left untreated can be very troublesome . And especially for those who go to job.
It is even troublesome for the couples who are sexually active. Normally when it begin conservative treatment using stool softeners, eating bulk forming diet, petroleum jellies, sitz bath, cleaning and antibiotic application.

If it doesn't cure with this and is present chronically for a longer time, a surgery to relax the adjacent muscle is done.

Like any other surgery, even this surgery as its own side effects like loosing the control of the anal sphincter. But the side effects can be minimized in experts hand and appropriate post operative care and pelvic muscle strengthening exercise which you can discuss with your surgeon before operation.

I hope I have answered your query adequately. For any other query feel free to write to me.

Above answer was peer-reviewed by
Follow-up: Multiple anal fissures, surgery, faktu, cremalax. Surgery a safe option ? 2 hours later

She felt some pain & bleeding a year before but at that time there were no visible symptoms. Doctor advised faktu & it cured in 2 days only.

Recently she took some medicine for acute cough n cold which created constipation.
just in two days of constipation she felt problem in passing stool. first day no bleeding and moderate pain but second day it was bleeding with severe pain. on doctor's advice she started applying faktu & cremalax and she cured in 5 days. Doctor said that she doesnt have piles/hammorhoids.

Now there is no pain & she started to go to work, still using cremalax as precaution but discontinued faktu & pain killer.

Doctor already suggested surgery (visibly fissure has 1 centimeter length & 0.5 centimeter dia), Doctor also said that this operation is very minor & she will be discharged on the same day. Recovery will take around one week & she has to avoid laboures work during recovery period. She did not told what operation she is going to do except its a minor operation.

Now we are in a fix that what we should do? Currently she have no problem except fissures are quite visible.
should we go for surgery or should we avoid it as long as it can be avoided.
Answered by Dr. Tulasi Raman.P 16 minutes later

Thanks for replying back.

If it is tolerated well & good, but the size you mentioned really bad.
If she is getting cured with faktu & cremalax you can see for few days or a week .If it doesn't heal surgery is better.
But always find out about the operation & its success rate, failure rate & the possible side effects & how to minimize that if it occurs. After having this information from the surgeon you will be able to decide whether to for the surgery or not. It cannot be done against your will. It can be advised to you & if best then will be said so.

I hope this is clear to you. No one can force or do any procedure blindly when you are asking for the details.
If you wish you can take a second opinion from another Doctor about the size & surgery before going for it.

If you have any more query write back to me .I will answer your query.
Above answer was peer-reviewed by
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