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Suggest Treatment For Recurring Anal Fissure
Question: Hello doctor
After undergoing treatment for anal fissure with GTN ointment n laxatives, the fissure recurred n doctor advised surgery.
I have been holding on to strict veg diet with lots of water n no spicy n oily foods. I guess my condition is better n bowels r soft n only sometimes i feel slight discomfort whn the dry stool comes out initially. I hav stopped all medication inluding laxatives. Is surgery necessity at this stage or should i giv time for fissure to heal on its own. Also i m experiencing pain around tailbone when going to standing position frm sitting. Is this connected with the fissure? Pls suggest me how i can heal my condition
After undergoing treatment for anal fissure with GTN ointment n laxatives, the fissure recurred n doctor advised surgery.
I have been holding on to strict veg diet with lots of water n no spicy n oily foods. I guess my condition is better n bowels r soft n only sometimes i feel slight discomfort whn the dry stool comes out initially. I hav stopped all medication inluding laxatives. Is surgery necessity at this stage or should i giv time for fissure to heal on its own. Also i m experiencing pain around tailbone when going to standing position frm sitting. Is this connected with the fissure? Pls suggest me how i can heal my condition
Brief Answer:
Surgery can wait and another treatment can be tried.
Detailed Answer:
Hello!
Thank you for the query.
How long have you had the fissure?
Nowadays, it is thought that only a small part of chronic fissures really needs a surgery. The treatment can last even a year. It needs to be regular and intense and can give chronic fissure healing. So if you have this fissure for few months, even a year, it is still time to try medicines. Surgery can wait.
Nitrglycerin cream (GTN) is only a one option. Please try to imagine a wound in a tight pipe which is constantly renewed by hard and wide stool. This is a fissure. Now to make it healed you need to make a pipe wider and make a stool softer and thinner. You need to do both at once.
To make a rectal muscle relaxed (this is our tight pipe) you have been using GTN. But you havent tried calcium channels blockers (like nifendipine or dilitiasem) and botulum toxin (botox). Both can make rectal muscle relaxed and both can help with fissure healing.
If its about the stool. It is very important to make it softer and regular. Laxatives are not the key. The key is fiber, probiotic and mineral water.
Next very important thing is to do not push hard on stool. When pushing on stool, you make the wound to reappear.
You may also try sitz baths with Oak Bark.
If its about tailbone pain, yes it can be related to the fissure. However it may be also caused by spine problem. Especially if the pain gets worse after physical activity.
Hope this will help. Feel free to ask further questions.
Regards.
Surgery can wait and another treatment can be tried.
Detailed Answer:
Hello!
Thank you for the query.
How long have you had the fissure?
Nowadays, it is thought that only a small part of chronic fissures really needs a surgery. The treatment can last even a year. It needs to be regular and intense and can give chronic fissure healing. So if you have this fissure for few months, even a year, it is still time to try medicines. Surgery can wait.
Nitrglycerin cream (GTN) is only a one option. Please try to imagine a wound in a tight pipe which is constantly renewed by hard and wide stool. This is a fissure. Now to make it healed you need to make a pipe wider and make a stool softer and thinner. You need to do both at once.
To make a rectal muscle relaxed (this is our tight pipe) you have been using GTN. But you havent tried calcium channels blockers (like nifendipine or dilitiasem) and botulum toxin (botox). Both can make rectal muscle relaxed and both can help with fissure healing.
If its about the stool. It is very important to make it softer and regular. Laxatives are not the key. The key is fiber, probiotic and mineral water.
Next very important thing is to do not push hard on stool. When pushing on stool, you make the wound to reappear.
You may also try sitz baths with Oak Bark.
If its about tailbone pain, yes it can be related to the fissure. However it may be also caused by spine problem. Especially if the pain gets worse after physical activity.
Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
doctor...i hav attached the prescription i ws given in August 2014. the fissure occured mayb 5 yrs ago but only became painful during bowel movement in dec 2013. Since thn its recurring. As of nw i m sticking to a high fiber diet with lots of water. Bowels r smooth n almost no pain is felt. except some mild pressure on that area. Will there b any complications if i delay surgery? I m not taking any medications. Also about the pain around tail bone area is not fm any physical activity. It only happens going fm sitting to standing position. Attached is xray of lumbar spine
Brief Answer:
No complications from postponing the surgery.
Detailed Answer:
Hi,
On the prescription aside from nitroglycerin cream, the rest of medicines is rather pointless.
There will be no complications if you wait with the surgery. You should also try Botulinum treatment. You should discuss it with a good proctologist.
Your spine x-ray looks fine. So the pain must be caused by fissure.
Regards.
No complications from postponing the surgery.
Detailed Answer:
Hi,
On the prescription aside from nitroglycerin cream, the rest of medicines is rather pointless.
There will be no complications if you wait with the surgery. You should also try Botulinum treatment. You should discuss it with a good proctologist.
Your spine x-ray looks fine. So the pain must be caused by fissure.
Regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi doc
Today i m experiencing increasing pressure n pain around buttock region n unable to sit long. Laying down give some relief. Can siltz bath help in this situation. Felt the sharp pain while passing stools today morning though stools were softs.
I m searching a botox treatment clinic in my area.Â
Can u pls suggest any medication for the pain around this area? it not directly from the anal section.
thnks
Today i m experiencing increasing pressure n pain around buttock region n unable to sit long. Laying down give some relief. Can siltz bath help in this situation. Felt the sharp pain while passing stools today morning though stools were softs.
I m searching a botox treatment clinic in my area.Â
Can u pls suggest any medication for the pain around this area? it not directly from the anal section.
thnks
Brief Answer:
Sitz bath can be helpful in this situation.
Detailed Answer:
Hi,
Yes, sitz bath can help (can be done with Oak Bark or if its not available, Potassium permanganate can be used for the bath as well). Oak Bark decreases inflammation and swelling.
For the pain you can use Lignocaine gel or Cataflam (from your prescription). Cataflam contains Diclofenac. It can be used twice a day. Sitz bath should also help with the pain.
Regards.
Sitz bath can be helpful in this situation.
Detailed Answer:
Hi,
Yes, sitz bath can help (can be done with Oak Bark or if its not available, Potassium permanganate can be used for the bath as well). Oak Bark decreases inflammation and swelling.
For the pain you can use Lignocaine gel or Cataflam (from your prescription). Cataflam contains Diclofenac. It can be used twice a day. Sitz bath should also help with the pain.
Regards.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Raju A.T
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