A fissure is a tear or cracks in the skin around the anus that can cause severe pain, especially during or after bowel movements. It may also cause bleeding. Though surgery is a possibility for chronic or destructive fissures, most cases can be easily treated without surgical intervention. Treatment may be necessary depending on the fissure's severity, its causes, and the person's general well-being.
Let's explore the conservative treatments available and when surgery might become necessary.
If proper care is taken early in the condition, most fissures can be cured without surgery. The following conservative methods are the most commonly used treatments:
1.Dietary Modifications
One of the best ways to treat a fissure without surgery is by preventing constipation, a major cause of fissures. Dietary changes can allow the body to produce softer stools, thereby lessening strain during defecation.
2.Stool Softeners
When diet is not enough, stool softeners may be prescribed. Drugs such as docusate sodium or psyllium husk may make stools softer, decreasing the strain on the affected area. They are used as a short-term measure while the fissure heals.
3.Topical Treatments
Various topical medications treat the pain and facilitate healing in the fissure region. These drugs relieve muscle spasms surrounding the anus, which alleviates pain and helps the area heal more effectively.
Topical medications, when combined with other treatments, may ease pain and allow healing in the majority of cases.
4.Warm Sitz Baths
A sitz bath in a shallow, warm water tub is an excellent method for relieving pain and aiding healing. The heat relaxes the anal sphincter, eases muscle spasms, and increases blood flow to the area. Sitz baths should be done ideally 10-15 minutes after each bowel movement, or several times daily, to gain maximum benefit.
5.Pain Relief
Over-the-counter medication, including acetaminophen or ibuprofen, may offer short-term relief from the pain experienced by fissures. They may be taken as needed but not regularly relied upon as the primary source of pain relief.
In most cases, anal fissures are successfully treated by non-surgical means. Fissures that do not heal with conservative treatment may require surgery. The following two procedures are most often employed:
1.Lateral Internal Sphincterotomy
This is the most common surgery for chronic fissures. It is a minor incision in the anal sphincter muscle to relieve and allow healing of the fissure. The procedure is typically performed under local anaesthetic and is highly successful.
2.Fissurectomy
Sometimes, if the fissure is very large or deeply located, a fissurectomy (removal of the fissure) may be performed.
Even if healed successfully, those with a background of anal fissures need to take preventive action to avoid recurrence. These consist of:
In most cases, fissures can be effectively treated without surgery using diet modification, stool softeners, topical remedies, and sitz baths. However, if the fissure becomes chronic or recurring, surgery may be an option.
Insurance companies like Star Health can also help make treatment more economical by paying for medications, consultations, and hospitalizations. Proper care and early intervention are required to avoid surgery and obtain permanent relief.