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What Causes Pain In Anal Fissure?

Posted on Sat, 29 Mar 2014

Question: hi i suffered from an anal fissure in XXXXXXX 2013. Was referred to a colorectal specialist in Nov 2013. I was prescribed diltiazam for 6 weeks. I think i was having an allergic reaction to it at the end of the 6 weeks as it became very painful. Then suddenly the sharp burning spasmodic pain very much eleviated and now only have a bit of a dull ache at the fissure site after BM. Dont know if it is healing or i need to go back and see the specialist again, not suffering from constipation or any thing like that.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer: Pain likely to be due to active fissure Detailed Answer: Hi Welcome to Healthcare-Mgic Greetings of the day Dear Ms, Pain in anal fissure is due to spasm of internal anal sphincter, which is induced in response to the fissure. Diltiazem is a calcium channel blocker, which causes relaxation of internal sphincter and relieving pain. Persistent pain even after using Diltiazem is not due to allergic reaction to the drug, but is due to persistent active fissure which is causing persistent spasm of internal sphincter. Majority of the patients presenting to me who have persistent pain , do have constipation. Even in few patients who do not have constipation, as in your case its important to ensure soft stools, as this will help in healing of fissure. You seem to have active fissure, which will require reassessment by your specialist. In the meantime,I would advise you following 1. Hot Seitz Bath: To tub of lukewarm water, add handful of common table salt. Sit in it for 15 to 20 minutes each session twice a day. Warmthness of water will relieve pain and spasm. 2. Consume plenty of oral fluids: 2 tp 3 liter a day 3. High fiber diet: Helps in fissure healing 4. Laxative like Lactulose will be helpful. Do Get back to me if you need any further assistance, will be glad to assist you. Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCH Consultant Surgeon

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

Follow up: Dr. Deepak Kishore Kaltari (1 hour later)

I do not experience the intense burning stabbing pains ad before but still have irritation and sometimes a dull ache after a bm that is not very soft but generally no intense pain after bm as eating a high fibre diet and plently fluids such as water. But agree i am not completely healed and may benet from another visit to the cororectal specialise

Answered by Dr. Deepak Kishore Kaltari (3 hours later)

Brief Answer: Wishing you great health Detailed Answer: Hi Greetings Whether the fissure has healed or not can be assessed by visual examination by your expert. Wishing you speedy recovery. Take Care Best Regards Deepak

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