How do you know if a fissure is healing? How to heal anal fissure? How to cure fissure permanently? Do fissures itch when they are healing?
About 9 out of 10 short-term fissures heal with home treatment—including using stool softeners or fiber supplements and taking regular sits baths. And about 4 out of 10 long-term anal fissures will heal after home treatment is used.
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But not all fissures will heal with just home treatment. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include nitroglycerin cream, high blood pressure medicines in pill or gel form, or injections of botulinum toxin (Botox).
If medicines don't stop your symptoms, you may need to consider surgery. The most commonly used surgery is lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.
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. Severe pain during a bowel movement followed by continuing pain is the classic symptom of an anal fissure.
. There is a vicious cycle of constipation causing pain, which makes the anal sphincter muscles go into spasm.
. This causes more pain and spasms, which makes having a bowel movement more difficult and worsens the constipation.
. The pain is significant enough to make sitting down even more painful.
. There also may be a few drops of bright red blood in the toilet bowel or when wiping, but significant bleeding usually doesn't occur.
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It plays the fundamental roles to note that complete healing with both medical and surgical treatments can take up to approximately 6-10 weeks. However, acute pain after surgery often disappears after a few days. Most patients will be able to return to work and resume daily activities in a few short days after the surgery. Pain during bowel movements usually goes away within a couple of days after the start of home treatment. There are several steps you can take to relieve your symptoms and help the fissure heal and try to prevent constipation.
A doctor can usually diagnose an anal fissure simply by examining the area around the anus using an endoscope may also help your doctor find other causes of anal or rectal pain such as hemorrhoids. In some cases of rectal pain, you may need an endoscopy for better evaluation of your symptoms.
. Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually.
. Drink adequate fluids. Fluids help prevent constipation.
. Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear.
Prescription drugs used to treat anal fissures that fail to heal with less conservative treatment are ointments containing anesthetics, steroids, nitroglycerin, and calcium channel blocking drugs (CCBs).
Your doctor may recommend:
. Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe.
. Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
. Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
. Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects.
Options of surgery for treating anal fissure involve Botulinum toxin injection into the anal sphincter and surgical division of a portion of the internal anal sphincter (lateral internal sphincterotomy). These two are performed typically as outpatient procedures. The aim of these surgical options is to promote relaxation of the anal sphincter, thereby decreasing anal pain and spasm, allowing the fissure to heal. If a sentinel pile is present, it may be removed to promote healing of the fissure.
All surgical procedures have some risk and both Botox injection and sphincterotomy can rarely interfere with one’s ability to control gas and stool. Your colon and rectal surgeon will discuss these risks with you to determine the appropriate treatment for your particular situation.
Special consideration is given to patients with established anal incontinence, known anal sphincter muscle injury (such as after obstetric injury) or diarrheal conditions (i.e., Crohn’s disease). In these select patients, surgical sphincterotomy must be considered carefully. A thorough discussion with your surgeon will identify any of these risk factors so the most appropriate treatment can be provided. Some patients may benefit from an alternative surgery called an anal advancement flap (anoplasty). Your surgeon will discuss this with you if this option is indicated.
Surgery by lateral sphincterotomy is the gold standard for curing anal fissures. Because of complications, however, it is reserved for patients who are intolerant of non-surgical treatments or in whom non-surgical treatments have proven to be ineffective.
Chronic anal fissures can be simply and effectively treated medically without the risk of incontinence associated with sphincterotomy. Topical nifedipine and botulinum toxin injections are an excellent combination, associated with a low recurrence rate and minimal side effects.
Treatments of chronic fissure:
. Botulinum toxin
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hi there, I was diagnosed with anal fissure 3 months ago and it started bleeding badly since 20 days ago but it has stopped for 2 days. I wanted to know if its healed?
hello, we suggest you see a general surgeon or colorectal surgeon and have a first hand examination so you can know how s your situation.
but in general bleeding or stopped bleeding won’t tell us anything about healing.
also the bleeding sometimes is due to piles in nearby region.but if there I no pain and pain has stopped it will show us some degree of healing.