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Dr. Andrew Rynne

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Suggest treatment for chronic anal fissure

Answered by
Dr.
Dr. Vasudha Jayant Athavale

General & Family Physician

Practicing since :1970

Answered : 7395 Questions

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Posted on Mon, 29 Aug 2016 in Digestion and Bowels
Question: Dear octor,
my elder sister is having chronic fissure problems since 15 years. 5 years back she consulted a doctor who advised her for surgery, but she did not agree and continued with light diet hot fomentation and ayuvedic medicines. she was keeping well and stopped taking any medicine. only concentrated on diet . but now since 3/4 months she is suffering from tremendous constipation with burning sensation whole day and only in the evening she gets some relief. she was a scientist by profession and now retired. she cant maintain her lifestyle due to too much burning , pain and uneasiness due to constipation. she takes isabgool husk every night. takes light diet takes hot fomentation, but no help. she has injury in anal area and some small pimples like growth ,she told. she is not willing to go to any physician. recently she took livofloxacin500 for 3 days,that has increased her constipation even more , she has discontinued the medicine. she does not have any diabetis, cardiac problem, kidney problem or thyroid and anemic problem. she does not have any bleeding symptoms while bowel movement. no fever , only pain and burning and consitipation. kindly prescribe something so that she can get some immediate relief. it is unbearale to see her suffering.she is five feet high weight 54 kg.
regards
doctor
Answered by Dr. Vasudha Jayant Athavale 4 hours later
Brief Answer:
Self help/ life style changes/ expert advise & treatment

Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for the query.I understand your concern.
Your sister has a chronic anal fissure with probably secondary infection/ inflammation.In such cases constipation adds to the trouble in bowel movements .. which in turn increases constipation & pain goes on increasing.
I would suggest for consultation of an anorectal surgeon for treatment of the infection / inflammation at fissure as well as detection of intestinal infection & infestation if any followed by needful management/ dilation of fissure under anesthesia( a miner surgery )to relieve the vicious circle of pain- muscle spasm- constipation & pain again .
* self care-By the time she gets appointment of Anorectal surgeon she can get some relief by-
- Using sitz bath two- three times a day.. followed bay pain relieving ointment over the counter ( like Anovate/ pilescura )/ use of glycerine suppository for adults before each defecation,
- use of stool softener like Cremaffin at bed time in the beginning,
- Taking excess fibers & water in diet.
Life style changes like routine abdominal exercises & walking for 45 minutes a day./ forming good bowel habits/ dietary supplements in form of fibers & lot of water/avoiding spicy, oily or fast food/Routine sitz bath help both in relief of pain & healing & prevention or recurrence/ a glass of warm water first time after getting up in morning facilitate bowel movements
I hope that answers your query. Any follow up query is welcome,
Thanks..
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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