Fissures are cracks that generally occur on the back wall of the anus. There is a bone structure behind this area, and strains during defecation mostly cause cracks in this area. In addition, the anus and its surroundings are very rich in nerves. It responds violently to the slightest stimulus and the patient suffers greatly.
Anal Fissure Treatment
The biggest reason for the formation of anal fissure is the increased pressure in this region. Chronic constipation is what causes this. Especially, excessive straining in the toilet or very severe bouts of diarrhea can cause these.
There are two types of muscle groups around the anus, which we call sphincters. 1 of these works voluntarily and 1 of them works involuntarily. In case of a crack, this involuntary muscle contracts excessively and disrupts the blood circulation there, causing the crack to become chronic. The aim of chronic fissure treatment is to eliminate this involuntary contraction.
Fissures can be seen at any age. Fissures seen in infancy are acute fissures. It gets better quickly with simple measures. If the fissure does not improve within 3 weeks, the event has become chronic and treatment should be planned accordingly.
The most obvious symptom in patients is severe pain during and after defecation. This pain begins with the contact of feces with the fissure. After defecation is over, it may last for hours, depending on the person. These pains and burning sometimes disrupt a person's daily life. It may lead to self-isolation in society. Patients describe the pain as pain like a glass cut when defecating.
Proctological diseases are diagnosed late due to the feeling of shame, and as a result, treatment is delayed. Since patients are not examined, these diseases are mistaken for hemorrhoids and necessary or unnecessary medications are given. In fact, sentinel pleats seen in chronic fissures are mistaken for hemorrhoids and even unnecessary surgery is performed.
Diagnosis is usually made by physical examination. The patient is placed in the knee-elbow position. This procedure is preferably performed on the proctology table. A vertical fissure is detected at the 12 o'clock position. Fibers of the internal sphincter muscle are seen on the floor of the fissure. In chronic cases, a sentinel breast called sentinel pile and a hypertraffic popilla are also seen. Rectal examination or anoscopic examination should not be performed in these patients. The patient feels severe pain. If it must be done, it should be done under local anesthesia.
In acute cases, patients are advised to stay away from spicy foods and turn to foods that leave pulp. Patients are advised to drink 3 liters of water a day. Sitz baths in warm water for 10 minutes every morning and evening will relax the anal sphincters and relax the patient.
In chronic cases, the aim is to eliminate anal spasm. There are 2 ways to do this. The aim of both is to reduce increased anal pressure. In both cases, 90-95% results are obtained.
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