What is an anal fissure? How is it treated?

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By injection; It is a popular method for non-surgical treatment of fissure. In the anal region, botulinum toxin is administered to certain points of the internal anal nerves to try to resolve the spasm in the muscle in the muscle. Its effectiveness, that is, the possibility of treatment and recurrence, is around 60-70%. In our clinic, the application is under sedation anesthesia and the success rate is tried to be kept to the maximum by using the original molecule and choosing the appropriate patient.

Can botox be applied to every fissure patient?

Not every patient and every fissure is suitable for botox injection.

Anal Fissure (Breech Fracture)

It is a tear or crack in the skin in the anus (breech) area. Although it is small in appearance, the discomfort is very evident. Tears in the first month are called “acute anal fissure”, and longer lasting tears with breast (swelling) are called “chronic anal fissure” (CAF). It can be seen in women and men at the same rates and in all age groups. Generally, the fissure begins superficially and can rapidly deepen and reach the underlying rectal inner muscle. In this case, the disease becomes chronic.

Anal fissure symptoms

The clearest symptom of breech fracture is PAIN and burning. This pain intensifies after defecation and may continue for 4-5 hours afterwards, some patients may experience a persistent pain. After defecation, bleeding may occur with the rupture of the fissure. These bleeding can be seen in the form of drops or fine lines on toilet paper. In rare cases, if there is a vein at the base of the fissure, severe bleeding may occur.

  • Causes of anal fissure
  • Constipation and hard stools
  • Too much straining
  • Severe diarrhea
  • Some diseases (Crohn’s disease and ulcerative colitis)
  • Pregnancy and childbirth
  • Strain of the anal muscles as a result of inverse relationship
  • Rectal trauma (enema, rectal thermometer, etc.)
  • Genetic factors

Treatment

Acute anal fissure heals easily with medical treatment and lifestyle changes. Diet, stool softening drugs, short-term topical creams, hot water sitz baths, painkillers are applied as treatment. The chance of success of drug treatment in early fissures is less than 80% with careful application. If recurrence occurs within 6-8 weeks despite treatment and all precautions, this situation is called chronic anal fissure.

Chronic anal fissure

A- Injection; It is a popular method for non-surgical treatment of fissure. By administering botulinum toxin to certain points of the internal anal nerves in the anal region, the muscle spasm in the muscle is tried to be resolved. Its effectiveness, that is, the possibility of treatment and recurrence, is around 60-70%. In our clinic, the application is under sedation anesthesia and the success rate is tried to be kept to the maximum by using the original molecule and choosing the appropriate patient. Not every patient and every fissure is suitable for botox injection. B- Surgical Treatment; Surgery is the only option for fissures that do not improve with lifestyle changes, drug treatments, sitz baths, stool softeners or botox injection. In our clinic, surgical closed LIS operation is applied in chronic anal fissures and the success rate is around 99%.


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Op. Dr. Akın Kocaoluk


Op. Dr. Akin Kocaoluk | Resume


He graduated from 19 Mayıs University Faculty of Medicine in 1998. He is currently continuing his active career in Turkish Red Crescent Altıntepe Medical Center.




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