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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Anal Fissure

Hello, I am diagnosed with Anal Fissure, and my doctor says I need a surgery and he will cut the muscle around my anus to relax it.. I am wondering if I really need a surgery? Can I fix it on my own? Are there any other ways to heal it other than a surgery? Thanks, Best, Gulce
Mon, 29 Aug 2016
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Internal Medicine Specialist 's  Response
An anal fissure is a small tear in the lining of the anal canal. Most people characterize it as a continuous knifelike tearing sensation especially on defection; some people will see bright red blood on the stool or when wiping. This forms as a result of high pressure within the anal canal (usually from constipation/straining) which leads to ischemia of the anal tissue and splitting of the anal mucosa during defection.

I would recommend:
-All measures to prevent constipation; avoid straining and prolonged sitting on toilet.
-Wash area gently with warm water
-Stool softeners such as docusate daily
-consume high-fiber diet and add daily fiber supplement such as psyllium
-increase fluids
-maintain healthy weight.
-your doctor can prescribe lidocaine gel for topical analgesics
-Sitz baths
-Avoid use of triple antibiotic ointment and long-term use of steroid creams to anal area.
-Most acute fissures heal within 6 weeks with conservative therapy. Medical therapy is less likely to be successful for chronic anal fissures; 40% failure rate.
-You need to be screened for infectious diseases or Crohn disease

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Suggest Treatment For Anal Fissure

An anal fissure is a small tear in the lining of the anal canal. Most people characterize it as a continuous knifelike tearing sensation especially on defection; some people will see bright red blood on the stool or when wiping. This forms as a result of high pressure within the anal canal (usually from constipation/straining) which leads to ischemia of the anal tissue and splitting of the anal mucosa during defection. I would recommend: -All measures to prevent constipation; avoid straining and prolonged sitting on toilet. -Wash area gently with warm water -Stool softeners such as docusate daily -consume high-fiber diet and add daily fiber supplement such as psyllium -increase fluids -maintain healthy weight. -your doctor can prescribe lidocaine gel for topical analgesics -Sitz baths -Avoid use of triple antibiotic ointment and long-term use of steroid creams to anal area. -Most acute fissures heal within 6 weeks with conservative therapy. Medical therapy is less likely to be successful for chronic anal fissures; 40% failure rate. -You need to be screened for infectious diseases or Crohn disease