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Chronic fissure, operated, but after defecation pains. Possible cause and treatment?

hi doctor, I am 30 yrs old ophthalmologist with no comorbids, i have chronic fissure in ano, operated 3 yrs back (lateral anal sphinterotomy) since then i felt better, few months ago started to have pain after defecation again, controlled with local xylocain, but the main problem is getting sever chills with fever few mints after defecation with sever body ache for 15 mints then after that i feel very tiered,
pls doctor it is realy troublesom me, i looking for your repaly
Asked On : Sat, 13 Apr 2013
Answers:  1 Views:  26
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General Surgeon 's  Response

Thank you for the query.

Your pain after defecation can be caused by fissure recurrence. However chills with fever can also indicate and infection. Due to inflammation of the rectum, fistula between the rectum and the skin could get created. This leads to an abscess in the anal area. Such abscess can give chills and fever, pain after defecation as well.

That is why I`m asking you to visit general surgeon and have rectal examination and rectoscopy to rule out this condition.
If its only a fissue you should:
- avoid constipation and make your stool soft (increase fiber rich products, mineral water intake, use stool softeners if necessary)
- do not push hard on stool
- use Nitroglycerine gel twice a day (it relaxes anal muscle)
- have sitz baths with Quercus Cortex twice a day
- wash your rectum after every stool

Hope this will help.
Answered: Sat, 29 Jun 2013
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