For a proper diagnosis and effective treatment, consult Dr. Samir Contractor.
An anal fissure is a tear in the lining of the anus. Fissures typically cause severe pain and bleeding with bowel movements. Fissure is often confused with other causes of pain and bleeding, such as hemorrhoids.
Anal fissures can occur in anyone at any age. However, people with fissures are more likely to have them in the future.
Fissures are usually caused by trauma to the inner lining of the anus. A hard, dry bowel movement is typically responsible, but loose stools and diarrhea can also be the cause. The injury to the tissue creates severe anal pain, resulting in anal sphincter spasms and a subsequent increase in anal sphincter muscle pressure. The increase in anal sphincter muscle pressure decreases blood flow to the injury site, thus impairing wound healing.
The trauma can be caused by one or more of the following:
Signs and symptoms of an anal fissure include:
Some of the possible complications of an anal fissure include the following:
Usually, your doctor can diagnose an anal fissure by visually inspecting the anus or by gentle exam with the fingertip or an anoscope.
Most fissures heal on their own and do not need treatment.The goal of anal fissure treatment is to lower the pressure on the anal canal by making stools soft and to ease discomfort and bleedingClinical guidelines on anal fissure management:
Your doctor will discuss the benefits and side effects of treatments. Treatment includes:
Lateral internal sphincterotomy (Laser Surgery)
Precise and controlled division of the internal anal sphincter muscle is highly effective and commonly used to treat chronic and refractory anal fissures. Success rates are reported to be over 90%. Recurrence rates after sphincterotomy are exceedingly low when adequately performed by a surgeon. Now a days this procedure is done with laser. In this technique there is no open wound and so no suturing is required. The surgery is performed as an outpatient, same-day procedure. The principal risks of internal sphincterotomy are variable degrees of stool or gas incontinenc
It is important to note that complete healing with medical and surgical treatments can take approximately 1-2 weeks. However, acute pain after surgery often disappears after a few days. Therefore, most patients can return to work and resume daily activities a few days after the surgery.
Fissures can recur easily, and it is pretty typical for a fully healed fissure to recur after a strenuous bowel movement or other injuries. Therefore, even when the pain and bleeding have subsided, it is crucial to continue good bowel habits and a diet high in fiber as a sustained lifestyle change.
Pilonidal means a ‘nest of hairs.’
A sinus tract is a narrow tunnel (a small abnormal channel) in your body. A sinus tract typically goes between a focus of infection in deeper tissues to your skin surface. This means that the tract may discharge pus from time to time onto your skin.
A pilonidal sinus is a sinus tract that commonly contains hairs. It occurs under your skin between your buttocks (the natal cleft) Rarely a pilonidal sinus occurs in other sites of your body.
Certain factors increase the risk of developing the condition and include:
Pilonidal disease is considered an acquired disease resulting from three main factors- the hair or foreign body, a force causing hair deposition into the sinus, and skin vulnerability.
The exact cause is not clear. There are various theories.
A similar condition can occur between the fingers of hairdressers, caused by customers’ hairs entering moist, damaged skin.
A pilonidal sinus affects the natal cleft.
Symptoms vary from mild to severe, depending on the presence or absence of infection
You need to keep the wound clean and the surrounding hairy area to be shave regularly to prevent recurrence.
Hair removal techniques : In some cases, hair removal may be the first step in treating a pilonidal sinus if an infection is not present.
Hair removal options may include:
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