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Having chronic anal fissure after delivery. Tried Beclomethazone dipropionate ointment. Taking lactulose syrup. Suggest?

May 2013
User rating for this question
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Answered by
Practicing since : 2006
Answered : 4909 Questions
Hello Doctor,
I just delivered a child and having a chronic anal fissure just after 2 weeks of child birth.I've had fissure 2 or 3 times even before delivery but that healed within a week or two. But at this time I have tried Beclomethazone dipropionate ointment for 2 weeks, Glyceryl trinitrate ointment for the next 2 weeks and now I'm using an ointment of Lidocaine, Hydrocortisone acetate,Zinc oxide, Allantoin for a week. I'm taking a lactulose syrup of 20ml every night with Antibiotics(Amoxyllin 500)&Paracetamol. I'm drinking an average of 3 & 1/2 litres of water everyday.

I met a surgeon and he suggested me a simple surgery. As i'm afraid of the surgery, i'm still following the above medications.
After trying all these, I suffer from a sharp pricking pain even after 3hours of defaecation. Its really hard to bear the pain and it gives a lot of discomfort. And from the past 2 weeks I find a blister on my sentinel pile tag. But I didn't find any kind of bad smell or pus from my anus. I want to know what is that blister? and why that has occurred? and what can I do to get healed from this pain? If surgery is the only solution, what kind of sugery it is?
How can I be assured that mine is not a serious incurable condition?
Posted Thu, 7 Nov 2013 in Abdominal Pain
Answered by Dr. Sree Gouri SR 1 hour later
Brief Answer:
Folliculitis, sitz bath

Detailed Answer:
Thanks for the query.
-The blister you mentioned could be a folliculitis.
-Usually some hair follicles will be present near the anal opening.
When the duct of the hair follicle gets occluded, folliculitis will occur.
-Moist environment near the anal opening, friction with clothes, excessive application of creams etc can favor this.
-To decrease the pain you can use combination of analgesic and anti - inflammatory drugs.
Sitz bath twice or thrice a day with XXXXXXX warm water in a tub and little bit of disinfect like dettol added in it, will give relief from pain.
You can use local antibiotic cream over the blister.
-The usual surgery performed for anal fissure is lateral XXXXXXX sphincterotomy.
-By examining the fissure doctor can come to one conclusion regarding the nature of the fissure.
If needed he can take one biopsy from the fissure to rule out serious conditions.
Hope I have answered your query. I will be available to answer followup queries. If you are satisfied with the answer, please give your review at the end of the discussion.
Take care.
Above answer was peer-reviewed by
Follow-up: Having chronic anal fissure after delivery. Tried Beclomethazone dipropionate ointment. Taking lactulose syrup. Suggest? 1 hour later
Hello Doctor,

Can you explain the surgery- lateral XXXXXXX sphincterotomy? Is it painful? How long does it take to recover from the surgery? Will my bowel movements be normal after the surgery or painful?
How should I prepare for the surgery?
I heard that even after surgery there are chances that fissure may occur again. what diet should I follow to prevent it from occurring again after surgery?
Answered by Dr. Sree Gouri SR 1 hour later
Brief Answer:
Procedure detailed below

Detailed Answer:
-In lateral XXXXXXX sphincterotomy, surgeon will cut the anal sphincter partially.
Once the sphincter is devided, pain will decrease and because of increased blood flow anal fissure will heal rapidly.
During the procedure sentinel pile can also be removed.
-As the surgery will be done under anesthesia, there will be no pain during the surgery.
-Usually it will take around one week for the external wounds to heal. Anal fissure can also heal in one week to ten days.
-After surgery, for few days the patient will be kept on intravenous fluids and oral liquids.
Once the wound heals solid diet will be allowed.
Usually many people will have normal bowel movements after surgery. Some people may have minimal leakage of stool for some time after surgery. And the ability to distinguish between stool and wind may be lost in some people.
Usually these problems will be temporary and many people can get complete cure.
-Preoperative preparation will be explained and done by the hospital staff after joining in the hospital.
-If constipation and straining for stools recur, the anal fissure may recur at same or at some other place.
-You should take diet XXXXXXX in fiber like fruits, green leafy vegetables, plenty of water etc.
Take care.
Above answer was peer-reviewed by
Follow-up: Having chronic anal fissure after delivery. Tried Beclomethazone dipropionate ointment. Taking lactulose syrup. Suggest? 2 hours later
Hello Doctor,

Thanks for the clarification!

One more query- Does this surgery have any bad after-effects? Will it affect my next pregnancy & delivery?

Note: I had a normal vaginal delivery for my 1st child now.
Answered by Dr. Sree Gouri SR 19 hours later
Brief Answer:
Usually won't affect pregnancy or delivery

Detailed Answer:
As I told previously, during early postoperative period you may have problems like leakage of stool etc.
But this will subside soon generally.
And the surgery as such won't affect your next pregnancy or delivery usually.
Take care.
Above answer was peer-reviewed by
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