Hello and welcome to Healthcare Magic. Thanks for your query.
Since you are having anal fissures which is causing pain while passing stools, its better to try medical management first. Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Taking sits bath twice a day (sitting in a tub of warm water with betadine
solution) Sits baths after bowel movements provide significant symptomatic relief because they relieve some of the painful internal sphincter muscle spasm. Second-line medical therapy is intra-anal application of 0.4% nitroglycerin
(NTG) also called glyceryl trinitrate, ointment directly to the internal sphincter.
If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, then I recommend you to consult a surgeon for appropriate surgical management. Surgery usually involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing. Surgery has a small risk of causing incontinence
. Depending on the severity of your fissure surgeons will be able to decide the surgical option and management. There are good surgical facilities available in India, so if you have the opportunity, you can consider this option also.
All the best.
Dr. Sheeba Stephen
Emergency Medicine Specialist