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Colorectal Diseases

Reoccurance of anal fissure

08/18/2003

Question:

i have been suffering from cronic constipation.four months ago anal fissure occured while passing stool.i took treatment like local application of lignocaine, high fibre diet, lactulose,metamucil and sitz bath.i got much relief and this fissure healed.but as i reduced dose of medicines it occured again few days ago and causing tremendus pain while passing stool and afterward nearly 4-5 hours. what should i do now?

Answer:

Chronic anal fissures can be difficult to heal, whereas acute anal fissures- such as the one you described- heal without intervention most of the time. A daily fiber supplement in addition to a high fiber diet is something you should continue indefinitely. A stool softener such as mineral oil can also be continued indefinitely. Sitz baths allow the sphincter spasm to ease, relieving pain, and are ok to continue. If these measures do not lead to relief within 10-14 days, you should visit a colon and rectal surgeon in your area to verify the diagnosis and discuss other options for treatment, such as topical nitroglycerine or diltiazem, botox, and surgery. 

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati