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Dr. Gervasio Salgado

anorectal diseases

Anal fissure Treatment

The treatment of this very painful entity should focus on relieving constipation and diarrhea, considering that most of fissures do not need surgical treatment. A fissure should be treated firstly with medication to relax the automatic anal muscle (internal sphincter) as in almost all cases of fissures this involuntary muscle is overly tight.

The topic treatment could last several weeks until the fissure is healed, however from the very first application, pain is considerably reduced. Other relaxants of the involuntary muscle, like the botulinum toxin, may be used specially on patients who tend to have incontinence (incapacity to retain the effluents, gas, stool, etc).

Surgery consists of a small operation to cut a short portion of the internal sphincter muscle (automatic anal muscle) in order to decrease the intensity of contraction in this area and help the fissure to heal. This is called Gold Standard, a definite and efficient treatment because pain disappears immediately and recurrence rate is low. The inconvenience of surgery (sphinterotomy) is that it may alter continence, particularly when applied to high-risk patients because of an extremely short anus or affected by previous childbirth, etc…

Anal Fissure