Fissures are painful and discomforting tears or cuts in the sensitive lining of the affected canal. Much like any wound on the skin, fissures can cause pain, bleeding, and discomfort, especially during bowel movements.
This article from Dr Amita Jain who is one of the leading fissure and piles surgeons in Delhi in the field of laparoscopic surgery sheds light on the causes of fissures, what to do if you suspect you have one, how they can be diagnosed, and most importantly, how they can heal without the need for surgery.
Causes of Fissures
- Passing Hard Stools: The act of passing hard stools can stretch the delicate mucosa, leading to tears and subsequent pain and bleeding. The tear can extend into the underlying muscle, resulting in persistent discomfort.
- Straining during Bowel Movements: Prolonged straining while attempting to pass stools can also cause injury to the area.
- Childbirth: In cases of prolonged labor, the opening of the part can be stretched, potentially causing injury and leading to the development of fissures.
- Inflammatory Diseases: Certain inflammatory conditions, such as Crohn’s disease or ulcerative colitis, can make the affected area more susceptible to fissures.
What to Do If You Suspect Fissure?
Fissures are notorious for the severe pain they cause. Some individuals, fearing the pain associated with bowel movements, may even avoid passing stools for extended periods. If you suspect you have an fissure, it is crucial to seek medical attention promptly. Consult with a physician or a surgeon for proper diagnosis and treatment.
Diagnosis of Fissures
During a medical examination, a surgeon will typically perform a per-rectal examination. This examination may reveal a tear in the rectal mucosa, sometimes accompanied by a tag. Due to the intense pain associated with fissures, the surgeon may avoid performing a proctoscopy unless there is a suspicion of an underlying condition. In such cases, additional tests like Colonoscopy and Sigmoidoscopy may be recommended.
Can Fissures Heal Without Surgery?
The good news is that fissures can often heal without the need for surgery. Proper treatment and precautions can facilitate the healing process. Here are several non-surgical approaches to consider:
1. Home Remedies: To relax the sphincter muscle and promote healing, you can try the following:
- Consume stool softeners.
- Maintain a high-fiber diet.
- Engage in regular exercise.
- Ensure adequate hydration by drinking plenty of fluids.
Additionally, avoid actions that may exacerbate the condition, such as straining during bowel movements, consuming stimulants like coffee and tea, eating spicy foods, or sitting for prolonged periods.
2. Medications: Several medications can aid in the healing of fissures:
- Topical nitroglycerin: Considered a primary medical treatment, it increases blood flow to the fissure and relaxes the sphincter, promoting healing.
- Topical anesthetic creams, like lidocaine hydrochloride.
- Botulinum toxin type A (Botox) injections: These can paralyze the sphincter muscle, reducing spasms.
- Blood pressure medications: Some medications can help relax the sphincter.
How to Gauge Improvement
You can assess the effectiveness of your treatment for fissures by monitoring these indicators:
- Pain subsides within a few days.
- Bleeding stops.
- Throbbing pain diminishes.
Preventing Fissures
To prevent the recurrence of fissures and support the healing process, consider these lifestyle changes:
- Keep the anorectal area dry, and use gentle, moistened materials for cleaning.
- Promptly address any constipation issues.
- Avoid irritating the rectum.
- Understand that fissures can recur, and it may require ongoing lifestyle adjustments to promote healing.
In conclusion, fissures are painful conditions, but with the right approach, they can often heal without surgery. Early diagnosis, appropriate treatment, and preventive measures can help you manage and recover from fissures, improving your quality of life. If you suspect you have a fissure, don’t hesitate to seek medical advice for proper care and guidance.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi