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What is the remedy for laceration above my anus?

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Practicing since : 2004
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Hi, I have a very deep laceration right above my anus that will not fully heal. What should I do?
Posted Thu, 6 Mar 2014 in Digestion and Bowels
Answered by Dr. Saumya Mittal 54 minutes later
Brief Answer: Anal fissures need surgery Detailed Answer: Hello XXXXXXX I am Dr Saumya Mittal, MD What you have is probably an extension of anal fissure. And most often the edges are uneven or ragged and they do not heal properly. In such a cases surgeons intervene to make these edges even and assist in healing. Usually patients of anal fissure have severe constipation if they try to heal without assistance. The hard stools on their passage through anus cause more lacerations. Thus the term anal fissures. It may happen with infections also. I will suggest you start stool softeners like lactulose, and isapghula. A high fiber diet is only going to help you. So diet rich in vegetables and fruits is recommended. You may also try Sitz bath. Its a solution you mix in warm water, and then sit in it for a while. The most effective treatment and the recommended treatment for this condition is surgical. So I would suggest you meet a surgeon in the area. I hope this helps. In case you have any further question, or if you want to know any further details, do feel free to ask them. I will be glad to respond. Dr Saumya Mittal.
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Follow-up: What is the remedy for laceration above my anus? 1 hour later
Hi, Thanks for the response. To be more clear, I had an accident surfing about 5 weeks ago, the nose of the surfboard cut a hole in my butt crack about an inch long and 1/2" deep, right above my anus. I went to the ER and the doctor put me on antibiotics and recommended no stitches because he thought it would heal on it's own. The doctor also said that I did not hit or puncture my rectum, and that it missed my anus by 1/2". Five weeks later the cut has mostly closed and I can feel the lump of scare tissue, but upon examining it a few hours ago, I think I opened it a little and smeared a tiny bit of blood on my finger. But not much more than a drop of blood. It's not really painful, though I think it may have caused me to develop a minor hemroid. Should i shower twice a day? Should I put antibiotic cream ointment on it? Should I try to super glue it closed? Is it okay that is smells a little fishy at the end of the day? Should I go see a doctor, if so which kind, even though I don't have health insurance? Thank you so much for your time and advice.
Answered by Dr. Saumya Mittal 3 hours later
Brief Answer: Need to rule out infection Detailed Answer: Hello again XXXXXXX Thanks for your further query and confidence in me. A laceration usually heals on its own. So I think that there is a possibility that the things will be fine. I am guessing it must have been a superficial wound, else sutures would have been required. I will suggest you upload a picture of the wound, if possible. There is a possibility that the wound may be getting infected, in view of the location. And so that would explain the possibly fishy smell. And an antibiotic would be needed. As for the blood, knowing how old your injury is, I would suggest that you meet a doctor again, preferably a surgeon, to make sure that there is no infection. An infection would mean delayed wound healing too. Being a dependant part, an area where you sit, a lot of pressure may be on the area. So healing may be delayed, but I would worry if it takes 5 weeks. Besides, a PT/INR, aPTT would be advisable. I would therefore suggest you to let me know the above details. If possible, get a swab culture from your wound. That would help us know what organisms are growing, in case there is an infection in the wound. Meanwhile do continue the stool softeners, in case defecation hurts you. I hope that answers your queries. Do respond if you need to ask a further query. I would be glad to help you with that. Dr Saumya Mittal
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