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Suggest Treatment For Infected Anal Fissure

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Posted on Thu, 3 Jul 2014
Question: Hi i am 23 , I had a fissure problem from a month, after scanning they decided that it was fistula inside anus at 7 clock position. I had a surgery for that before 15 days, for the first week it seems to be reducing but it doesnt. Now continous pus is coming out inside anus. It is very much painful when I go to toilet. My surgeon told me it will decrease by time. But pain is increasing everyday. Please tell me what is my condition.is it recurring or healing?
how many days I have to bear this unbearable PAIN.
doctor
Answered by Dr. T Chandrakant (50 minutes later)
Brief Answer:
Proper care- second opinion

Detailed Answer:
Hi.
Thanks for your query.

I would like to ask you before answering your query:
Do you have a Discharge card? if yes - please scan and post attached to this query ( we have this beautiful facility- you can also post actual photographs of good quality for us to see the wound)

Ideally speaking the healing after 15 days of surgery has to be very good and the wound should have been painless or with bearable pain, no active pus coming at all.

This can occur because of few things::
The healing is delayed due to improper cleaning
You have stopped antibiotics
The original cause could have been like tuberculosis or such diseases. Did they send the tissue for biopsy/ histopathological diagnosis.

I would suggest::
Very thorough cleaning of the wound with hydrogen peroxide, liquid povidone iodine ( Betadine), and dressing with sterile pads to be changed twice daily. This is the most important part as the wound at the anus will be contaminated with fecal matter every time you pass a motion.>>
For this the best way to have a Proper Sitz bath. You should have a large bowl that can allow you to sit in a squatting position in a warm water (nothing to be added please), Sitz bath is done before and after you pass motion; the cleaning of the fecal matter has to be thorough with a wet cotton ball during Sitz bath and after with hydrogen peroxide and betadine.
Repeat the Sitz bath in the late evening before you change the sterile dressing.
This alone is going to help you get a proper control of infection and pain too.

You need to take oral antibiotics as per Your Doctor's advise ( we can not write prescription-needed antibiotics here ) Add Vitamin A and D in therapeutic doses followed by anti-oxidants ( multi-vitamins). This helps in early healing. Continue Trypsin and take Aceclofenac only if there is pain. You can request for Tramadol from your Doctor to be taken half an hour before motion/ dressing.

Reduce the dose of laxative to make stool soft- NOT loose stool. You need to have well formed stools for a natural dilatation. Take ''FULL- diet"" as you were taking before Surgery.

Request your Doctor to examine you under general anesthesia and do corrective surgery if He feels so. Or you are also free to take another opinion of another Surgeon... Our aim should be an early and complete recovery.

IF necessary you can also request for any other tests he You Surgeon thinks so. This can be MRI also to know whether there is any ''pocketing '' of pus. This is not uncommon. And I hope your do not have any medical condition like anemia, hypoprotinemia, diabetes or so. ( all these delay healing).

I hope this will help you a lit to see a change within a few days... Just follow: this is the general care all patients should undergo.

Wishing you early and complete recovery





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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19777 Questions

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Suggest Treatment For Infected Anal Fissure

Brief Answer: Proper care- second opinion Detailed Answer: Hi. Thanks for your query. I would like to ask you before answering your query: Do you have a Discharge card? if yes - please scan and post attached to this query ( we have this beautiful facility- you can also post actual photographs of good quality for us to see the wound) Ideally speaking the healing after 15 days of surgery has to be very good and the wound should have been painless or with bearable pain, no active pus coming at all. This can occur because of few things:: The healing is delayed due to improper cleaning You have stopped antibiotics The original cause could have been like tuberculosis or such diseases. Did they send the tissue for biopsy/ histopathological diagnosis. I would suggest:: Very thorough cleaning of the wound with hydrogen peroxide, liquid povidone iodine ( Betadine), and dressing with sterile pads to be changed twice daily. This is the most important part as the wound at the anus will be contaminated with fecal matter every time you pass a motion.>> For this the best way to have a Proper Sitz bath. You should have a large bowl that can allow you to sit in a squatting position in a warm water (nothing to be added please), Sitz bath is done before and after you pass motion; the cleaning of the fecal matter has to be thorough with a wet cotton ball during Sitz bath and after with hydrogen peroxide and betadine. Repeat the Sitz bath in the late evening before you change the sterile dressing. This alone is going to help you get a proper control of infection and pain too. You need to take oral antibiotics as per Your Doctor's advise ( we can not write prescription-needed antibiotics here ) Add Vitamin A and D in therapeutic doses followed by anti-oxidants ( multi-vitamins). This helps in early healing. Continue Trypsin and take Aceclofenac only if there is pain. You can request for Tramadol from your Doctor to be taken half an hour before motion/ dressing. Reduce the dose of laxative to make stool soft- NOT loose stool. You need to have well formed stools for a natural dilatation. Take ''FULL- diet"" as you were taking before Surgery. Request your Doctor to examine you under general anesthesia and do corrective surgery if He feels so. Or you are also free to take another opinion of another Surgeon... Our aim should be an early and complete recovery. IF necessary you can also request for any other tests he You Surgeon thinks so. This can be MRI also to know whether there is any ''pocketing '' of pus. This is not uncommon. And I hope your do not have any medical condition like anemia, hypoprotinemia, diabetes or so. ( all these delay healing). I hope this will help you a lit to see a change within a few days... Just follow: this is the general care all patients should undergo. Wishing you early and complete recovery