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Any Chance That Anal Dilation Worsens The Anal Fissures?
Hi, is there any chance that anal dilation even worsens the anal fissures ? If I undergo dilation, what are the chances that anal fissures will completely heal so that I dont get pain while passing even hard stools in future? Does the sentinel pile need to be cut off or only dilation will suffice? Can sharp pain be caused by anything other than anal fissure also? Sometimes sharp pain is not there even passing hard stool and sometimes it is there even passing soft stool. How can this be? Can my anal sphincter also be tight which is causing anal fissures? What are the possible remedies for tight anal sphincter? Sometimes a burning pain starts after bowel movement. Is it also because of fissure?
Tue, 3 Jan 2017
Hello and welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
Anal dilation as a procedure for treatment of anal fissures has fallen out of favor due to high rate of incontinence associated as you can imagine and if surgical procedure has to be done, the lateral internal sphincterotomy is the procedure of choice. There can be other causes of sharp pain as well such as external hemorrhoids, however it should be diagnosed on digital rectal exam. Even soft stool at times can irritate the fissures that may cause pain.
Initially the medical treatment should be pursued with topical nitroglycerin and diltiazem, and you should use it for about 3 months. If that does not work, surgical procedure can be considered only at that time.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Muhammad Gul
I have reviewed your query and here is my advice.
Anal dilation as a procedure for treatment of anal fissures has fallen out of favor due to high rate of incontinence associated as you can imagine and if surgical procedure has to be done, the lateral internal sphincterotomy is the procedure of choice. There can be other causes of sharp pain as well such as external hemorrhoids, however it should be diagnosed on digital rectal exam. Even soft stool at times can irritate the fissures that may cause pain.
Initially the medical treatment should be pursued with topical nitroglycerin and diltiazem, and you should use it for about 3 months. If that does not work, surgical procedure can be considered only at that time.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. Muhammad Gul
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