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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for anal fissure

Answered by
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16943 Questions

Posted on Thu, 29 Oct 2015 in Lump
Question: I have what i thought to be an anal fissure. Its a single lesion and is getting slightly bigger. There was bught red blood on tissueabout 3 weeks ago.
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
May be a fistula- need actual examination and investigations

Detailed Answer:
Thanks for your query and clear picture.
Yes there is a fissure in the anal and perianal area.
This is mostly in the front (anterior) or back part (posterior).
The picture shows this in the lateral position.
If there is pus formation and discharge from this it may be a fistula in ano.

For this you need a clinical examination, per-rectal digital (finger), proctoscopy examination to start with preferably done by a General Surgeon to get the probable diagnosis as this alone can guide the further treatment for cure.

May I please know a few things for me to assist you more:
- Since when have you got this problem?
- How are the bowels movements- is the stool hard?
- Any other problems like diabetes or any other medical problems?
- Any other history that you would like to share which you feel may be related to unrelated to the present problem?

The photo also shows that you have inter-gluteal dermatitis. This usually occurs due to the following factors and is treatable.
Take proper long courses of Anti-oxidants that is multivitamins.
Clean the area with copious plain water, make it dry with hair dryer, apply liquid povidone iodine to the whole area and let it dry up.

Rest of the treatment depends upon the clinical findings on actual examination and additions tests of blood, urine, stool and so on.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. T Chandrakant 20 minutes later
I was a little constapaited abiut 1 week prior. It started as what looked like a small cut and is now in the state shown in the photograph. I did have a hemorrhoid about 4 months ago. It seemed to clear up with the use of Preparation H. I had anal sex and there was some bright ted blood on a toilet tissue. It felt like i just had a minior bit o tissue trauma. Other than that under a ton if stress at work and i had what i think was a fever about 3 dats ago, but the freling lasted under 8 hoursf
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
Looks to be traumatic one

Detailed Answer:
Thanks for your feedback.
This is what I thought about the moment I saw the photo.
This looks to be a tear during anal sex.
Was it a protected one or without condom?

I would advise you the following:
High fiber diet.
Avoid all the foods and beverages and stress-like conditions which gives constipation.
Laxative for softening the stool- never allow the dose too much to cause liquid stools.
Sitz bath- very important- just before passing a stool and after passing a stool.
Clean the area very clear of the fecal soiling that remains after cleaning; use cotton soaked in the same water to clean.
You can apply liquid povidone iodine locally. Apply nothing else.
5 day course of an antibiotic on prescription of a local Doctor.
Add probiotics and multivitamins.
Avoid stress and mental tensions at any cost; this is a very important factor.

All these things under the guidance of a General Surgeon or Proctologist, examination and investigations as he would ask for.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. T Chandrakant 3 hours later
Thank you very much for your time.
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
You are most welcome.

Detailed Answer:
Thanks for your appreciation.

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

The User accepted the expert's answer

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