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Anal fissures

An anal fissure is a common condition that causes painful bleeding or rupture at the surface of the anus or rectum. This sometimes manifests as pain and even bleeding through bowel movements. An anal fissure is a tear in the lining of your anus. The two sides of the inner muscular tissue called the internal and external sphincters, come together, making way for a special cushioning system to push stool away from the anus. Anyone who has had an anal fissure has likely heard plenty of terms used to describe it. If you or someone you know ever has experienced this condition, here's what you need to know about it.

Acute fissures are those that have been present for under six weeks. A chronic fissure is one that is older than six weeks. The Sentinel Pile, which resembles a skin tag and may be present in the Chronic fissure, is typically difficult to feel.

Symptoms

Patients who have painful defecation may put off going to the bathroom because they are terrified of it.

• As a result, constipation and hard stools are exacerbated, creating a vicious cycle of trauma and hard stools.
• The pain associated with defecation can be severe, prickling, or searing, and the subsequent burning may last for several hours.
• Blood on the tissue or a blood stain on the feces can occasionally be used as indicators of bleeding.
• When the anal sphincter spasms, it becomes necessary to strain while passing stools.

Treatment

1. MCDPA

Dr. Ashwin Porwal created the following MCDPA regimen at Healing Hands Clinic:
Medicines - Herbal remedies to lessen localized inflammation
Before bed, take Constac to give your stools more weight and soften them.
Diet: Consume a diet high in fibre to avoid constipation. Increasing fluid and water intake is also beneficial.
Physiotherapy - Pelvic floor physiotherapy aids in lowering anal sphincter spasms.
Ayurvedic therapy employs the use of medicinal herbal oils.

2. Sitz bath

A sitz bath involves sitting in warm water that covers the hips and buttocks, usually after bowel movements. This age-old method helps relax the anal muscles, reduces pain, and improves blood flow to promote healing. Though simple, it is highly effective and commonly advised by specialists.

3. Nitroglycerine Ointment

Nitroglycerine ointment is applied locally to relax the anal sphincter muscle. By reducing muscle spasm and pressure, it improves blood flow to the fissure, aiding healing—especially in chronic fissures.

4. Nifedipine ointment

Nifedipine ointment works similarly by reducing sphincter pressure and relaxing the muscles around the anus. This helps relieve pain and allows the fissure to heal naturally over time.

5. PLIS (Partial Lateral Internal Sphincterotomy)

PLIS is a minimally invasive surgical procedure performed under local anesthesia. A small incision is made to partially release the tight internal sphincter muscle, reducing pain, straining, and pressure during bowel movements.

6. Laser Surgery for Fissure

Laser fissure surgery uses advanced laser technology to perform internal sphincterotomy with high precision. The Leonardo laser, first introduced in India at Healing Hands Clinic, allows faster healing, minimal pain, and reduced recovery time compared to conventional surgery.

How to Spot an Anal Fissure?

Diagnosis is usually straightforward and based on symptom history along with a gentle visual examination of the anal area. In rare cases, further tests may be advised to rule out underlying conditions contributing to delay healing.

Conclusion

Botox treatment has gained popularity as a non-surgical option for chronic anal fissures. It works by temporarily relaxing the anal sphincter muscle, allowing the fissure to heal naturally. If you have tried medicines, diet changes, and topical treatments without success, Botox may be an effective alternative before considering surgery.