Anus fissure, which is a disease that causes severe pain and sometimes bleeding during and after defecation as a result of a wound in the form of cracks at the exit of the anus, can be so severe that it distracts the person from his daily life. Anadolu Health Center General Surgery Specialist Assoc. Dr. Abdulcabbar Kartal said, “However, the real pain occurs at the end of defecation and can last for hours. Tears may occur in the anus, especially in cases of difficult defecation for any reason or diarrhea where the anus is very irritated. These tears cause spasm in the muscles, and they are exposed to more pressure and the possibility of spontaneous healing of the tear decreases because their blood circulation is insufficient.
Underlining that the diagnosis of anal fissure can be easily made by a careful physical examination after a good anamnesis (patient history) is taken from the patient, Anadolu Medical Center General Surgery Specialist Assoc. Dr. Abdulcabbar Kartal said, “There is usually no need for any examination to be made for the diagnosis. However, it is often misdiagnosed and patients are tried to be treated with some unnecessary and useless drugs such as 'hemorrhoids' treatment, sometimes hemorrhoid surgery can be performed on patients. One of the reasons for this is that a small breast forms outside in a few weeks in fissures and this breast is confused with the hemorrhoid breast.
Correct defecation recommendations should be made to the patient.
General Surgery Specialist Assoc. Dr. Abdulcabbar Kartal said, “However, finger examination and endoscopic examination should not be performed until a patient with acute fissure is partially relieved. The patient's defecation habit should be questioned in detail and correct defecation recommendations should be made.
High fiber diet is important
General Surgery Specialist Assoc. Dr. Abdulcabbar Kartal said, “In the second stage, patients should be told that their eating habits should be changed in order to make their stools soft. “Patients should consume at least 4 liters of water a day and should be fed a diet rich in fiber and pulp.” Underlining that it would be beneficial for patients to consume dried apricots and figs and various herbal teas to soften the stool and prevent constipation, Assoc. Dr. Abdulcabbar Kartal said, “If the stool does not soften and constipation continues, this problem should be solved with some medications. Because solid defecation will cause serious pain where the crack is, and patients will delay their toileting so that there is no pain. This will cause a vicious circle,” he said.
Surgery is the last resort
Stating that the next step in the treatment of anal fissure is the injection of botulinum toxin, popularly known as “botox”, Assoc. Dr. Abdulcabbar Kartal said, “This method, which is successful at a rate of about 70 percent, is temporarily effective with partial paralysis of the breech muscles. If problems such as constipation and straining are not resolved, the probability of recurrence is very high in this method. Emphasizing that the last resort in anal fissure is surgery, Assoc. Dr. Abdulcabbar Kartal said, “In surgery, the inner part of the muscles that contract the anus is cut, increasing the blood circulation of the wound and spontaneous healing. Although the success rate is around 98-99 percent when done correctly, it should be considered as the last option, especially in female patients, since it can cause problems such as incontinence of gas in 3-5 percent of patients, stool incontinence in case of diarrhea, and the treatment of these problems is almost impossible.