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Suggest Treatment For Chronic Anal Fissure

Posted on Sat, 10 Sep 2016

Question: I have anal fissures from Parkinson's Disease effect on the internal sphincter. I need to keep my stool as soft as possible. I now take 400 units of Colace a day, Amitiza and occasionally, coconut oil. I have had Botox injections in my anus and that helped but it is important that my stool be as easy to pass as possible. Can you advise?

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello and Welcome

I appreciate your concern

If Anal Fissures get chronic then they are difficult to heal by diet and medication alone. Topical metronidazole, Posterisone forte (Phenol:0.3%w/w, Hydrocortisone:0.25%w/w) and local anesthetics like lidocaine are commonly used to facilitate healing and avoid infection. You are right Constipation further aggravates the matter and should be avoided by using ispaghula husk with cremaffin suspension. Both in combination lead to softer stool and easy evacuation.

A rectal exam would be required to gauge the severity of the fissure. A lateral internal sphincterotomy or a fissurectomy can be embarked upon in consult with a General surgeon or Proctologist. The pain of anal fissure due to the spasm of the sphincter is quite severe and is relieved adequately with a sphincterotomy done in time.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

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Dr. M.S. Khalil

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar