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Conservative treatment of anal fissure

The anus is located at the very end of the gastrointestinal tract. It measures about 3-6 cm, and is surrounded by muscles jumpers – in both the inner and outer. An anal fissure is caused by cracks in the inner layer of the membrane, causing the wound. The most common cause of constipation are, as a result of which the voter stool is quite hard and causes excessive stretching of the anus. As often as the reason given also loose stool, IE. diarrhea. In this case, the digestive juices leaking out, teasing around the anus, reducing flexibility and exposing the cracks. Anal fissure runs along the long axis of the anal channel, usually from the back, rather than vaginal or scrotum.

Symptoms of anal cleft

Pain and bleeding are the basic symptoms accompanying the formation of anal fissures. Intensify during defecation, and usually resolve spontaneously. However, in some cases, the pain lasts longer, interfering with daily functioning. Given the size of the wound, can be bolstered or discreet, as well as sharp or burning. Sometimes it is accompanied by a burning sensation and discomfort in the perineal area.

The bleeding also occurs when passing stool. Blood stains can be seen on the toilet paper, toilet bowl or faeces. If the bleeding lasts longer, can be also seen on underwear. Often alongside the blood also appears moist discharge, depositing on the edge of the anus.

Both these symptoms typically occur in the early stages of the disease when an anal fissure is a fairly fresh-sharp. Over time, they softened, however, it is possible their recurrence, especially during defecation.

The course of the disease

These symptoms do to discourage visits to the toilet, but it is a kind of vicious circle. Procrastination passing stools leads to constipation. Dense stool, eliminated by a narrow channel, the edges of the wound, by repeating the injury.

Because the anal fissure is moving its adherence, wound edges and heal is clearly difficult. For stretching occurs not only during defecation, but also during normal walking, sitting down or standing up.

Over time, anal fissure may lead to irritation of the sphincter. The wound opens up more and more and deepens, and the edges of the grubieją, becoming inflamed follicular lymphomas. Inside the anal fissures can be observed then the muscle fibres of the internal anal sphincter, calm by the wound. As a result, the impossible becomes the control over its contractions, which leads to the problem of defekacją. The anal canal is becoming increasingly tighter, and stool increasingly deepened the wound. In this way, acute anal fissure, turns into a chronic wound.

Although the symptoms you get used because intensify and subside periodically, anal fissure may lead to further changes. Hypertrophy of the wound causes anal fissures, as a result of which form lumps called pseudopolipami (external) and warts (internal).

An anal fissure is acute and chronic

In some cases, to distinguish between acute anal fissures from chronic is extremely difficult. The primary determinant of acute cases is the duration of up to 3 weeks. Gap, which lasts longer, becoming chronic status. In other cases, assessment is the appearance of the wound. Chronic fissure has larger, thick edges, and in its interior you can see fibers of the sphincter. For the gap, on the other hand, the characteristic are pseudopolipy, warts and crevices between them. The diagnosis last is proof that the patient has long been struggling with the problem.

Remember, however, that maintenance treatment acute anal fissures treatment is much easier. If the diagnosis of diseases of the will in the first phase, it will be possible to treatment of non-leading to the total elimination of the likelihood of recurrence of the disease. In the case when an anal fissure lasts a few weeks, no way will avoid surgery.

Treatment

To identify an instance of an anal fissure, it is necessary to perform the research. Most specialist shall decide to carry out:

  • endoscopy – anoskopii, rectoscopy, sigmoidoscopy or colonoscopy
  • ULTRASOUND of the abdomen
  • study of biochemical blood

Anoskopia is watching the anus and lying over it, the rectum. Rectoscopy covers the entire final episode of the colon. This study uses. dwudziestocentymetrowy view window. Using 3 x longer equipment shall be carried out sigmoidoskopię, which gives a picture of anus, rectum, and also the last part of the sigmoid colon. During a colonoscopy, the large intestine is examined, along with its parts: odbytnicą, esicą, zstępnicą, cross, wstępnicą and kątnicą. Endoscopic studies allow not only to check the State of individual sections of the colon, but also for possible download slice from the space covered by the changes or possible removal of the tumor.

Treatment of acute wounds is usually conservatively. In this case an anal fissure disappear even after a few weeks. It is recommended that:

  • change your diet, in order to have regular bowel movements and soft stool
  • good hygiene of the anus
  • use your anal sphincter muscle ointment.

Treatment of chronic anal fissures, the recommendations are only 10-15% of cases. If the anal fissure reaches the chronic nature, it is recommended that:

  • injecting preparations causing relaxation of the anal sphincter muscle, in the longer term,
  • surgical treatment

The decision about the proper treatment of anal fissure physician specialist. Conservative methods do not carry the risk of complications behind them, however, do not apply in the case of chronic wounds.

Treatments with the use of a variety of preparations are often high costs, and significantly reduce the recovery period. Most commonly used measures, which reduce the voltage of the internal sphincter anal channels:

  • NITROGLYCERIN-reduces tension and improves blood circulation to the anodermy, allowing healing of anal fissures
  • Botulinum toxin A (Botox) – works similar to Nitroglycerin, but most often it is recommended in case of unsuccessful treatment or relapse of the disease
  • Calcium channel blockers: Dilitiazem and Nifendipina – with their use of treated persons suffering from chronic anal fissure
  • Hyaluronic acid – helps the regeneration of the mucous membrane, accelerates the healing of wounds, mostly used in the alternative

The most effective method, however, is surgery, during which the anal fissure is cut. Despite this, it is interesting to note that it carries a risk of complications.

Regardless of the choice of treatment, will need periodic check-ups, for recurrence of the disease or possible complications, for example. in the form of okołoodbytniczej fistula or abscess okołoodbytniczego.

Remember that the sooner you report to, the faster you get rid of persistent problem. If left untreated, anal fissure can lead to a number of complications. Leaving a doctor's appointment for later, run the risk of complications as a result of complex treatments and prolonged period of treatment. Think about it!

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