COMPLEX TREATMENT OF CHRONIC ANAL FISSURE
Comprehensive treatment of chronic anal fissure — restoring comfort and quality of life
What is an anal fissure?
An anal fissure is a longitudinal defect in the mucous membrane of the anal canal, which occurs due to trauma, chronic constipation, inflammatory diseases, or increased muscle tone of the sphincter.
In the early stages, a fissure may heal on its own, but without treatment, it becomes chronic: the edges thicken, scar changes appear, inflammation and spasm of the anal sphincter develop, which hinders healing. As a result, the patient experiences constant pain, bleeding, itching, and fear of defecation, significantly reducing the quality of life.
Symptoms of chronic anal fissure:
- Sharp or burning pain during and after defecation
- Drops of blood on toilet paper or in stool
- Spasm of the anal sphincter and a sensation of a "foreign body"
- Itching, burning, and moisture
- Fear of going to the toilet, chronic constipation
If symptoms persist for more than 4–6 weeks, it is a sign of the fissure becoming chronic, requiring comprehensive treatment.
Principles of comprehensive treatment:
The modern approach to therapy for chronic anal fissure includes not only eliminating the defect but also addressing all causes that support its existence: inflammation, spasm, stool disorders, and local blood circulation.
Treatment is selected individually and usually consists of the following stages:
1. Conservative therapy (in the early stage):
- Prescribing mild laxatives to normalize stool
- A diet high in fiber and adequate water intake
- Local anti-inflammatory and healing ointments
- Use of antispasmodics and nitrate ointments to relax the sphincter
- Sitz baths with antiseptics and herbs
- Laser therapy and physiotherapy to improve blood flow
Conservative treatment is effective in the early stages or as a preparatory stage for surgical intervention.
2. Minimally invasive and surgical methods (in chronic cases):
If the fissure does not heal within 4–6 weeks, surgical treatment is indicated. Modern methods allow the problem to be resolved quickly, without pain and prolonged rehabilitation.
- Lateral sphincterotomy: The most common method of surgical treatment for chronic fissure. Performed under local or spinal anesthesia, the surgeon makes a microscopic incision in the internal sphincter, eliminating the spasm and creating conditions for healing.
- Botulinum therapy: Injections of botulinum toxin relax the sphincter and improve blood supply to the mucosa, promoting natural healing of the fissure without incisions.
- Excision of the chronic fissure: Removal of scarred edges and inflamed tissue followed by mucosal restoration — the procedure takes 20–30 minutes and ensures quick healing.
Advantages of a comprehensive approach:
- Elimination of pain and bleeding in the first days of treatment
- Addressing all links of pathogenesis — the cause is completely eliminated
- Rapid healing and restoration of the mucosa
- Minimal risk of recurrence
- Short rehabilitation period (5–10 days)
- Significant improvement in quality of life
Recommendations during the recovery period:
- Follow a soft diet high in fiber
- Avoid constipation and excessive straining
- Maintain thorough hygiene of the anorectal area
- Follow all proctologist's prescriptions and attend follow-up examinations
Complete healing usually occurs within 2–3 weeks, and a return to normal life is possible within 5–7 days after a minimally invasive procedure.
Comprehensive treatment of chronic anal fissure is not just about eliminating the defect but fully restoring the health of the anorectal area. Modern methods allow for pain relief, comfort restoration, and prevention of recurrences without prolonged rehabilitation.
An anal fissure is a longitudinal defect in the mucous membrane of the anal canal, which occurs due to trauma, chronic constipation, inflammatory diseases, or increased muscle tone of the sphincter.
In the early stages, a fissure may heal on its own, but without treatment, it becomes chronic: the edges thicken, scar changes appear, inflammation and spasm of the anal sphincter develop, which hinders healing. As a result, the patient experiences constant pain, bleeding, itching, and fear of defecation, significantly reducing the quality of life.
Symptoms of chronic anal fissure:
- Sharp or burning pain during and after defecation
- Drops of blood on toilet paper or in stool
- Spasm of the anal sphincter and a sensation of a "foreign body"
- Itching, burning, and moisture
- Fear of going to the toilet, chronic constipation
If symptoms persist for more than 4–6 weeks, it is a sign of the fissure becoming chronic, requiring comprehensive treatment.
Principles of comprehensive treatment:
The modern approach to therapy for chronic anal fissure includes not only eliminating the defect but also addressing all causes that support its existence: inflammation, spasm, stool disorders, and local blood circulation.
Treatment is selected individually and usually consists of the following stages:
1. Conservative therapy (in the early stage):
- Prescribing mild laxatives to normalize stool
- A diet high in fiber and adequate water intake
- Local anti-inflammatory and healing ointments
- Use of antispasmodics and nitrate ointments to relax the sphincter
- Sitz baths with antiseptics and herbs
- Laser therapy and physiotherapy to improve blood flow
Conservative treatment is effective in the early stages or as a preparatory stage for surgical intervention.
2. Minimally invasive and surgical methods (in chronic cases):
If the fissure does not heal within 4–6 weeks, surgical treatment is indicated. Modern methods allow the problem to be resolved quickly, without pain and prolonged rehabilitation.
- Lateral sphincterotomy: The most common method of surgical treatment for chronic fissure. Performed under local or spinal anesthesia, the surgeon makes a microscopic incision in the internal sphincter, eliminating the spasm and creating conditions for healing.
- Botulinum therapy: Injections of botulinum toxin relax the sphincter and improve blood supply to the mucosa, promoting natural healing of the fissure without incisions.
- Excision of the chronic fissure: Removal of scarred edges and inflamed tissue followed by mucosal restoration — the procedure takes 20–30 minutes and ensures quick healing.
Advantages of a comprehensive approach:
- Elimination of pain and bleeding in the first days of treatment
- Addressing all links of pathogenesis — the cause is completely eliminated
- Rapid healing and restoration of the mucosa
- Minimal risk of recurrence
- Short rehabilitation period (5–10 days)
- Significant improvement in quality of life
Recommendations during the recovery period:
- Follow a soft diet high in fiber
- Avoid constipation and excessive straining
- Maintain thorough hygiene of the anorectal area
- Follow all proctologist's prescriptions and attend follow-up examinations
Complete healing usually occurs within 2–3 weeks, and a return to normal life is possible within 5–7 days after a minimally invasive procedure.
Comprehensive treatment of chronic anal fissure is not just about eliminating the defect but fully restoring the health of the anorectal area. Modern methods allow for pain relief, comfort restoration, and prevention of recurrences without prolonged rehabilitation.
