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Dr QM Leong

Anal Fissures: Surgical and Non-Surgical Treatments

Man standing and holding on the back side in the toilet. Concept hemorrhoids

If you experience excruciating pain during or after bowel movements, you might be suffering from an anal fissure. This condition can impact your daily life, making each trip to the bathroom uncomfortable.

Fortunately, anal fissures can be treatedIn this article, we discuss both surgical and non-surgical treatments for anal fissures, helping you make informed decisions about your well-being.

Anal fissures are small tears in the anus lining that make bowel movements uncomfortable and painful. The pain may also be accompanied by itching, bleeding, and a visible tear in the skin around the anus. These fissures can affect anyone but are particularly common in adults aged 15 to 40.

Anal fissures are caused by:

  • Constipation: Hard, dry stools can cause tears as they pass through the anal canal.
  • Diarrhoea: Frequent loose or watery stools can irritate and tear the anal lining.
  • Childbirth: Women may develop fissures due to the strain of delivery.
  • Anal Intercourse: This can cause trauma to the anal lining.
  • Underlying Conditions: Conditions like Crohn’s disease can cause chronic inflammation of the intestines, leading to fissures.

Non-Surgical Treatment Options

Most anal fissures can be managed with non-surgical treatments, especially if addressed early. Here are some effective non-surgical options.

Dietary Changes

Changing your diet is one of the simplest ways to treat and prevent anal fissures. Key dietary changes you can implement include:

  • High-Fibre Foods: Incorporate fruits, vegetables, whole grains, and legumes for softer stools and make them easier to pass.
  • Hydration: Drinking plenty of water helps keep stools soft.
  • Avoiding Irritants: Limit intake of spicy foods, caffeine, and alcohol, which can irritate the digestive tract.

Medications

You can manage symptoms and promote healing of anal fissures with medication. These include:

  • Stool Softeners: Over-the-counter stool softeners can ease bowel movements.
  • Topical Anaesthetics: Creams or ointments containing lidocaine can reduce pain.
  • Nitrate Ointments: These help relax the anal sphincter and enhance blood circulation to the area, promoting healing.
  • Calcium Channel Blockers: Applied topically, these medications relax the anal sphincter muscles.

Sitz Baths

A sitz bath means sitting in warm water for 10-20 minutes several times daily, particularly after bowel movements. The warmth can soothe pain and itching, while increased blood flow to the area aids in healing. Regular sitz baths will also help maintain hygiene and prevent infection.

Lifestyle Modification

Changing your lifestyle can also support the healing process and prevent recurrence. Consider the following:

  • Regular Exercise: Being physically active can help prevent constipation and promote digestive health.
  • Proper Bowel Habits: Avoid straining during bowel movements, and go to the bathroom when you feel the urge.
  • Good Hygiene: Gently clean the anal area with water, and pat dry after bowel movements.

Surgical Treatment Options

If non-surgical treatments fail to heal the anal fissure or if it becomes chronic, your doctor may recommend surgery. Understanding the preparatory steps for anal fissure surgery in Singapore is crucial for a successful outcome.

Lateral Internal Sphincterotomy

Lateral internal sphincterotomy is the most common surgical procedure for treating anal fissures. This surgery has a high success rate, relieving pain and promoting healing. A small cut is made in the internal anal sphincter muscle. The cut helps reduce the muscle tension, allowing the fissure to heal.

Non Surgical Alternatives

  • Botox Injections: Botulinum toxin can be injected into the anal sphincter to paralyse the muscle, reducing spasms and pain temporarily.

Post-Surgery And Recovery

After surgery, proper care and adherence to recovery guidelines are essential:

  • Pain Management: Pain is usually minimal after surgery but can be managed with prescribed medications.
  • Wound Care: Clean the surgical site and keep it dry, and follow your surgeon’s instructions for wound care.
  • Diet: Continue a high-fibre diet and stay hydrated to prevent constipation.
  • Activity: Avoid straining yourself for a few weeks, but do light exercise as your doctor recommends.
  • Follow-up: Attend all follow-up appointments to ensure proper healing.

How To Choose The Proper Treatment

Choosing the right treatment for anal fissures depends on the severity of the fissure, your overall health, and your response to initial treatments. If you’re trying to understand your symptoms, our explanation on anal fissures vs fistulas and their causes might help clarify your doubts.

It is best to speak to your healthcare provider about your symptoms and treatment options so you can discuss which treatment option is suitable for you. It’s essential to understand the recovery timeline if you opt for anal fissure surgery in Singapore. If distinguishing between an anal fissure and haemorrhoid seems challenging, our blog provides a clear explanation of the four main differences.

Consult A Colorectal Specialist For Anal Fissure Treatment And Surgery In Singapore

For personalised care and expert advice on treating anal fissures, consult the specialists at Advanced Colorectal & General Surgery. Our team of experienced colorectal surgeons in Singapore provides complete care, from diagnosis to treatment and recovery. We offer non-surgical and surgical options tailored to your needs, ensuring the best possible outcomes.

Schedule a consultation today.