0hrs : 20min
An Anal fissure is a crack in the anal canal. It results from increased pressure within the anal canal, which can be due to constipation, passing large hard stools or frequent loose stools. It develops with equal frequency in both males and females. Usually younger and middle aged people are affected the most.
Fissures are of two types, primary or secondary. If the cause of the anal fissure cannot be identified, it is known as a Primary fissure. If the anal fissure is due to an underlying cause like an infection, it’s a Secondary fissure.
Sphincterotomy is the surgical treatment of anal fissures. The muscle that controls the passing of stools is called the internal anal sphincter and it is under constant tension. By “sphincterotomy” we mean “cut into”(-otomy) the anal sphincter. Doing this, helps release the pressure within the anal canal, which in turn helps in the spontaneous healing of the fissure. The procedure has been shown to be very effective. In 96% of patients, the fissures closes completely in 3 weeks time.
How is Sphincterotomy Performed
A small incision is made over the anal skin.
The surgeon inserts an instrument to keep the anal canal open during the procedure.
He locates the internal anal sphincter and makes a tiny cut over this muscle.
This releases the existing tension within the anal canal.
The cut area is left open.
This closes in 2-3 weeks time, and along with it, the anal crack heals too.
Chronic anal fissure results in spasm of the internal sphincter leading to constipation. This procedure is as simple as cutting a ribbon, so it’s better to undergo this procedure and get relieved of the symptom.
Life after sphincterotomy
- Use a donut ring while sitting.
- Sitz bath in the evening. A sitz bath is a shallow bath filled with warm water and helps keep the area clean and decreases pain.
- Eat high fibre food.
- Drink lots of water.
Dr. J. S. Rajkumar
M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)
Dr. Prabhakaran Raju
Consultant Surgical Gastroenterolgy
M.B.B.S., M.S (GENERAL SURGERY), Mch(SGE)