What is a fissure?
The tear in the anus skin is called anal fissure or crack. Although the size of this crack is quite small (between 5-10 mm), it disturbs the person very much due to the high pain sensation in the anus area.
It is usually seen in young and middle-aged people.
Bleeding in the anus. It is often confused with hemorrhoids, which are the most common diseases that cause pain and swelling. However, the complaints of these two diseases are similar and the treatments are different.
What is the cause of the crack?
The stool, which usually hardens after constipation, causes the very thin anal skin to tear during defecation. . As constipation and thus hard stools continue, tearing recurs with each defecation, and the tear does not have the opportunity to heal. When the anus is opened during defecation, the crack also opens, causing severe pain. Patients who are afraid of this pain do not want to defecate. This causes the feces waiting inside to become even more solid. Eventually, the stool becomes harder and more irritating to the wound (crack). This continues in a vicious circle.
What are the symptoms?
Pain during defecation (this pain continues after going to the toilet), small amounts of bleeding and constipation. , sometimes small palpable swelling are the main symptoms. Additionally, itching and stinging may occur while sitting.
How can it be understood that there is a crack?
Just seeing the crack by the relevant specialist is sufficient for diagnosis. There is no need for any examination.
Can't the cause of my complaints be another disease?
If the patient's complaints and examination findings match, another disease is not considered. However, if the appearance of the crack is different, there are many cracks, and there are different complaints that may suggest other diseases, additional research is required.
What is additional research?
Some diseases of the large intestine. It may cause crack formation in the anus. In this case, it is necessary to treat the main disease, the intestinal disease. To investigate the presence of such a disease, it is necessary to perform a colonoscopy. Sometimes blood tests may be performed.
How is the treatment of cracks?
The essence of the treatment is to correct constipation and prepare the ground for the healing of the crack. For this purpose, stool softeners and pain relieving ointments are used. Sitting on a hot water bottle is also very helpful; It both relieves pain and increases blood flow to the anal area for wound healing. It is also recommended to have a diet rich in fiber (plenty of fruits and vegetables, whole wheat bread, plenty of water, apricots, figs, etc.) to relieve constipation.
Stretch marks that have just started (newer than a month) and whose appearance gives hope for improvement can be treated with medication. They improve proportionally. However, cracks that do not improve with medication or have become chronic are treated with surgery.
How is the surgery for the crack?
Anal fissure surgery is applied to the anal area that constantly contracts due to pain and therefore It is the process of increasing blood flow by cutting a portion of the muscle group that causes decreased blood flow. Most of the time, no treatment is applied to the crack itself. However, if the palpable swelling at the tip of the crack is excessive or if it is necessary to accelerate wound healing, the crack can be removed.
This surgery can be performed with local anesthesia, or with anesthesia from the waist or completely anesthetized. However, it is preferred to have the procedure under general anesthesia for reasons such as short duration, anxiety, and feeling of embarrassment.
Are there any side effects of the surgery?
Rarely due to muscle cutting, There may be a complaint of gas leakage.
How long does it take to return to normal life after the surgery?
After this surgery, patients can usually go home on the same day. There may be a small amount of bleeding and pain during the first defecation; In the future, these complaints also disappear. Normal life is returned the next day. If there is pain while sitting, sitting on a hot water rubber is sufficient.
Does the crack recur after the surgery?
The success of crack surgery is very high and recurrence is not common. However, the patient should not be constipated after the surgery and should take measures to ensure wound healing.
Is there any treatment method other than surgery?
New (acute) cracks should be treated other than surgery. It is also possible to improve it with some procedures (such as Nitric oxide, calcium channel blockers, botylium toxin). surgery Among the methods, botulinum toxin injection, known as BOTOX, is a useful method for suitable patients with positive results.
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