Anal fissures can be broadly classified as “Acute” or “Chronic” based on their duration and characteristics.
An Acute Anal Fissure resembles a fresh cut and responds well to conservative or non-surgical methods. About 60% to 70% Anal fissures usually heal within 2-3 weeks with the help of medicines.
When Acute Anal Fissure fails to heal for more than eight weeks, it is termed as Chronic Anal Fissure. Such fissures develop excessive swelling, scar tissue, and skin tags. These fissures usually respond to surgical intervention due to continuous pain, spasms, and tissue ischemia.
Understanding the type of anal fissure is crucial for determining the appropriate treatment strategy. Here is a comparison of key characteristics:
Acute Anal Fissure:
Chronic Anal Fissure:
Anal fissures are often the result of trauma to the sensitive lining of the anus. The primary cause is typically the passage of hard or large stools, which can lead to tears in the anal canal. Other common factors include:
Less frequently, anal fissures may be associated with:
Some of the most common symptoms of Anal Fissures are:
It's crucial to differentiate these signs from other colorectal conditions, such as hemorrhoids, which may present similarly.
Early recognition and treatment of anal fissures are essential to prevent complications and improve outcomes.
This is mainly indicated for acute anal fissures, which are associated with mild to moderate anal spasms. These include:
Lifestyle and Dietary Changes:
The basis of treating anal fissures begins with simple lifestyle and dietary adjustments aimed at preventing constipation and reducing strain during bowel movements. This is achieved with:
Topical Treatments
Local application of certain ointments provides relief from discomfort and promotes healing.
Medications
Oral medications may be prescribed to manage symptoms and support healing.
Botox injection is one of the minimally invasive treatment options for chronic anal fissures. Botox injection is injected into the internal anal sphincter muscle. It causes temporary paralysis of the muscle.
As a result, the tone of the muscle decreases, and the spasm and tightness of the anal canal significantly decrease within a few hours.
This causes relief from pain while passing stools and allows fissures to heal within a couple of days.
Laser Surgery for Anal Fissures: When conservative treatments and medications fail to heal the fissure, surgical options may be necessary. Surgery is typically reserved for
Lateral Internal Sphincterotomy performed with the help of Laser therapy has become the best treatment for anal fissures. It involves making a small incision in the internal anal sphincter muscle to reduce tension and promote healing.
It is usually performed as an outpatient procedure, and patients are discharged within 12 hours of surgery.
With almost 100% healing rates and zero percent recurrence, laser surgery for anal fissures is one of the most promising treatments for management of anal fissures.
Laser surgery is usually recommended for severe acute anal fissures and chronic or recurrent anal fissures that do not respond to conservative treatments. Your surgeon will evaluate your condition and determine if laser surgery is the most suitable option for you.
Yes, there are several non-surgical treatments for anal fissures. It depends upon the condition of the anal fissure and the pain and spasm associated with it. Discuss all available options with your doctor to find the best approach for your situation.
The success rate of laser surgery varies, but it is generally very high for resolving symptoms of anal fissures. The success rate also depends upon the surgeon's expertise and the quality of the laser machines. We boast of an almost 100% success rate in the management of anal fissures following laser surgery.
You can expect a significant decrease in pain following laser surgery, and pain completely subsides in four days during the passage of stools. However, recovery may vary depending on the condition and chronicity of the anal fissure.
Most of the patients can be discharged within 12 hours of surgery. You do not require bed rest and can gradually resume your normal activities within 24- 48 hours of surgery.
The Botox treatment for anal fissure is a simple procedure and the patients get discharged within 3 hours of procedure. The recovery is very fast and the results are excellent with almost zero risk of complications.
The best treatment for anal fissure depends upon the pain, severity of symptoms and the complexity of fissure. Depending upon these factors, the surgeon can recommend you non-surgical options, Botox injections or laser surgery. We strongly believe that treatment should be customized and tailored according to the condition of the patient.
Proper diagnosis, choosing the right modality of treatment, avoiding constipation and maintaining a healthy life style ensures almost zero chances of recurrence. However, prolonged constipation and inadequate treatment of anal fissure can result anal fissure coming back in 2-3% of patients.
Dr. Kapil Agrawal, with over 23 years of experience, is well known for his expertise in the management of colorectal conditions, including anal fissures. He has been associated with top-notch hospitals in Delhi, ensuring access to the best facilities and medical care.
Dr. Kapil Agrawal's comprehensive treatment approach addresses all aspects of anal fissures, focusing on curing the condition with medicines in 70% of patients, thereby avoiding invasive procedures.
Dr Kapil Agrawal’s expertise ensures a high success rate with Botox injections, demonstrating our commitment to effective, patient-centric care.
He utilizes the best quality laser machines, ensuring optimal results and almost zero recurrences, setting him apart in providing cutting-edge treatment.
Dr Agrawal’s team includes dedicated nutritionists who provide customized diets to promote healing and prevent constipation, ensuring a holistic approach to treatment.