Anal fissure : symptoms, treatment , surgery , causes

Recently fairly urgent problem was the anal fissure.When hemorrhoids and colitis crack ranks 3rd on repetition frequency in the population.

Anal fissure - it is a tear or ulcer between the edge and the dentate line of the anus.

In the supine position the crack is located along the semicircle and the midline of the anus.Crack is a slight defect in the mucous membrane of the anal canal up to 1 cm.

most often appears in young people, but it is not excluded at any age.This disease is characterized by men with different sexual orientations.Anal fissure is the most common proctology disease, the cause of which is the violation of a chair.

Causes of anal fissure Anal fissure


appears due to mucosal injury anus due to untimely or defecation disorders chair.The main factors of the disease is considered:

  • constipation;
  • solid stool;
  • diarrhea;
  • hemorrhoids.Hemorrhoidal nodes easily weaken the walls of the anus.Because of this, the gut is injured during defecation;
  • proctitis;
  • hard work;
  • sedentary lifestyle, prolonged sitting;
  • bowel wall injury by sharp foreign bodies;
  • circulatory disorders in the anal opening.It is typical for people who prefer a long time to sit on the toilet;
  • intake of spicy food or alcohol.
The reasons also include birth injuries, gastrointestinal diseases, weakening of the pelvic muscles, injuries of the rectum.Anal fissure is accompanied by severe pain, due to the fact that the injury causes a spasm of the muscles - sphincter, holding the stool.Spasm impedes wound healing, so the crack is difficult to treat.They often occur when several precipitating factors.When passing

hard stools, diarrhea, mucous broken, this leads to the formation of cracks.With the normalization of the chair, the forecast is quite optimistic.If the disease is started, then the anal canal inflammation occurs because crack is not cleared due to increased pressure, hiding behind the folds.There are a lot of pain as spasm of the sphincter is enhanced.

symptoms of anal fissure Anal fissure


has severe symptoms, which manifest themselves pain during defecation.After a bowel movement can stop the pain, but it often happens that the disease becomes chronic, and the patient experiences constant pain.

There is not pronounced bleeding on the toilet paper are traces of blood.Also, as mentioned above there sphincter spasm.

pain after defecation act lasts up to several hours.which is why patients with anal fissure becomes irritable and nervous.Patients also fear going to the toilet, because of this stool even more condensed, and bowel wall injured.

If a person just does not apply to a specialist, usually self-healing does not occur.The crack may increase in volume, there is a chronic disease.

treatment of anal fissure


Diagnosis is made when viewed from a doctor.Sometimes colonoscopy bowel prescribed inspection being performed under local anesthesia, need further blood tests.

When anal fissure treatment can be conservative or surgical.

Nonsurgical treatment


  1. 1) Normalization of stool.To do this, the patient is prescribed mild laxatives - Duphalac, Normase, Forlaks, Prelaks based on lactulose component.Recommend to use a sufficient amount of fiber, and up to 2 liters of fluid each day;
  2. 2) Diet therapy.The patient should be excluded from the diet, spices, spicy food, alcohol.Meals should be regular and balanced.The day should eat up to 200 grams.fresh or cooked vegetables, fresh juices and fruits;
  3. 3) Sit-bath effective for muscle relaxation and health.Recommend defecation after taking the bath with a decoction of sage and chamomile.Be sure to carry out procedures before going to bed;
  4. 4) Medication.Patients prescribed 0.2% nitroglycerin ointment or on the basis of diltiazem or nifedipine.After 4-8 weeks of acute fractures heal successfully.Just designate methyluracyl candles natalsid the morning and before going to bed;
  5. 5) Injection of Botox into the internal sphincter to the local disinfection.
facilitate the patient's condition and normalize the chair can use enemas.Laxatives microclysters based on sunflower oil and water well to defecate.After defecation recommended hip baths, then you must enter into the anal canal buckthorn candles.If the patient experiences pain, they do lidocaine blockade.

Pain docked, resulting in accelerated wound healing.This procedure is a contraindication - the presence of the haemorrhoid.

In more than 70% of the cure occurs after non-surgical conservative treatment.So do not rush to go under the surgeon's knife!To start with 100% follow all doctor's advice on hygiene, treatment, healthy habits.

should be noted that during the treatment of anal fissure should not lift weights, and do not succumb to unnecessary physical strain.Not recommended as the hot water treatment.

Surgical treatment of anal fissure


Running excision defect is dissected one of the parts of the anal sphincter (sphincterotomy).The result is relaxation of the sphincter, the pain disappears obsession, and create conditions for a successful wound healing.This operation does not require an extended hospital stay, and the main thing is that the muscles are not cut leads to undesirable consequences, ie,content is not broken stool.

Although in some cases there are complications, as the cut goes almost blindly, sphincter fibers can not sufficiently nasech or cross.

undesirable effects after surgery include bruising, pain or urinary retention.In the future may appear bowel fistulas or recurrent disease.

Currently there spasm of modern methods of treatment using pnevmodivulsii procedure.The diameter of the anus is measured using a cylinder that opens under pressure at the time of surgery.

This helps remove only the affected areas of radio wave method, and cutting the sphincter is not required.The wound heals up to 3-4 weeks, the patient is discharged in 2-3 days without any complications.

Why is difficult to heal anal fissure?


Crack has a lot of exposed nerve endings, and at the slightest touch appear severe pain.

A frequent stools or constipation pain, sphincter spontaneously reduced.As a result, the crack is constantly injured, broken and difficult to heal.

Prediction and prevention


Proper treatment helps successful healing of anal fissures.Often patients are embarrassed to see a doctor, and a long time is used all sorts of drugs and candles.

development of chronic forms requires surgery.Modern methods of diagnosis and treatment can successfully fight the disease.It is important to carry out preventive measures, is the basis of normalization of stool and mobile lifestyle.

The diet should include foods rich in fiber (beet, prunes, melons, apricots, kiwi).It is necessary to drink up to 2 liters, which include fluids - juice, fruit drinks, sour - milk products, mineral water.

Complications


to main complications include inflammation of the rectum, abscess.Develops inflammation of the mucosa of the anal canal infection.In the inner and outer edges of the anal fissures often appear anal or guard bumps, because of which in the future may appear fibrous polyp.

Because anal fissure can spoil life for even the most patient person, recommended time to see a doctor-proctologist.Be healthy!


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