Information of Anal Fissure

  • Anal fissures:-        Anal fissures are cracks or tears in the anus and anal canal. They may be acute or chronic.

    • Pathogenesis.
      More than 90% of fissures that are not associated with Crohn's disease occur in the posterior midline. The remainder occurs in the anterior midline. Fissures associated with Crohn's disease may occur at any location within the anal canal.
    •  An anal fissure is a tear in the lining of the anus, usually resulting from the difficult passage of hard stool. Some fissures are a consequence of a more generalized bowel disorder, such as Crohn's disease. Others result from the trauma of anal intercourse or insertion of foreign bodies. Rarely, carcinoma of the anus presents as an anal fissure.
    • Clinical presentation. Anal fissures are painful, and the pain is exacerbated by the passing of stool. The pain may lead to a cycle of retention of stool, formation of hard stool, passage of hard stool, and aggravation of the fissure. Bleeding and itching also are common. Anal fissures often coexist with hemorrhoids.
      External examination by spreading the patient's buttocks and anal orifice may reveal the fissure. Digital examination usually is quite painful for the patient and thus the rectal examination may be limited. Sometimes the fissure or a mass of granulation tissue can be palpated. Preliminary application of a topical anesthetic decreases the discomfort of the digital rectal examination and subsequent sigmoidoscopic examination.
    • Diagnostic studies
      • Anoscopy and sigmoidoscopy should be performed to make the definitive diagnosis and to rule out other conditions mentioned in section I, in the discussion of hemorrhoids.
      • Scraping the fissure. If the cause of the fissure is suspected to be sexual, a scraping of the fissure should be examined under dark field illumination to consider the possibility of a syphilitic lesion.
      • Radiologic evaluation. Patients whose fissures fail to heal or who have fissures that are not in the midline should undergo radiologic evaluation of the large and small bowel for Crohn's disease.
THE TREATMENT OF ANAL FISSURE IS SIMILAR TO THAT OF HEMORRHOIDS: HIGH-BULK DIET, STOOL SOFTENERS, WARM BATHS, AND LUBRICATING SUPPOSITORIES. MOST FISSURES HEAL ON THIS REGIMEN.
Homeopathic medicines are very effective in management of anal fissure  . The point to be emphasized is that the relief of symptoms is obtained with absolute gentleness and without invasion or surgery of any kind. Homeopathic medicines work at the root level and can modify these genetic tendencies thus reducing chances of relapse and recurrence of the condition significantly. 
success rate is very good and we have treated effectively many patients .