Sahara Hospital (Mon - Sat: 9AM - 4PM)

Alyantra Medicity Super Speciality Hospital (Mon - Sat: 4PM - 7PM)

Neera Hospital (Mon - Sat: 7PM - 8PM)

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Treatment

  1. Home
  2. Treatment

FISSURE


Anal Fissure is a tear, cut or crack in the lining of anal canal.

Symptoms

  • Visible tear in skin around anus
  • Painful defecation while passing stools and post defecation. Pain is pricking or searing type and can last upto hours
  • Bleeding (streak of blood) on stools or blood on the tissue paper
  • A skin tag like growth can be felt at the edge of the fissure called as Sentinel pile
  • Need to strain while passing stools due to anal sphincter spasm
  • Pruritus ani – Itching in the anal region.
  • Malodorous discharge

Causes

  • Passing large or hard stools due to constipation
  • Diarrhoea – repeated bowel movement causes tearing of the anal skin.
  • Childbirth
  • Crohn’s disease, leukaemia, tuberculosis
  • Sexually transmitted diseases like Syphilis
  • Viral infections like Herpes
  • Decreased blood flow to anorectal area

Type

  • Fissure can be present in men, women or even infants.
  • Acute Fissure : Fissure that is less than 6 weeks old
  • Chronic Fissure: Fissure that is more than 6 weeks old
  • Sentinel pile: Chronic fissure that is hard to feel and has a skin tag like growth near the fissure.

Diagnosis

  • History of symptoms
  • External examination

FISTULA


An anal fistula is a small channel that can develop at the end of the bowel and the skin near the anus. It is generally formed due to previous or current anorectal abscess. An anorectal abscess starts off due to anal gland infection. This infection then progresses to an abscess which is pus filled. An abscess further progresses to become an anal fistula when the abscess doesn’t heal completely with or without treatment.

Symptoms

  • Continuous dull or throbbing pain accentuated on sitting
  • Foul smelling discharge of pus and blood
  • Swelling, tenderness, itching or redness around the anus
  • Painful bowel movements

Causes

  • Anorectal abscess (50% of the times abscess turns into a fistula)
  • Crohn’s disease, Diverticulitis, etc due to inflammation of the intestines
  • Infections such as Tuberculosis
  • Sexually transmitted diseases- HIV, etc
  • Latrogenic – A tear during insertion of a rectal thermometer, USG probe, endoscope, enema tube
  • Anorectal cancer

Diagnosis

  • Brief history with clinical correlation and digital rectal examination.
  • Proctoscopy to check for any associated condition in the rectum.
  • MRI Fistulogram in case of complicated fistulas where tract is different to comprehend

Types

  • Type 1 (Inter-Sphincteric) : Tract formed in the spaced between the two anal sphincters
  • Type 2 (Trans-Sphincteric) : Tract passing through both the sphincters
  • Type 3 (Supra-Sphincteric) : Tract loops over both internal & external sphincter through the pelvic floor muscle
  • Type 4 (Extra-Sphincteric) : Tract from rectum to skin without involving the sphincters