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Anal Fissure & Fistula In ANO

Anal Fissure & Fistula In Ano

introduction

Fissure-in-Ano depicts a break in the lining of the anus due to extreme stretch during a passage of a large hard motion. Severe pain in that area will cause spasm of the anal sphincter and prevent further passage of motion causing increased constipation. This condition is often seen in girls and young women. They usually get scared going to the toilet because of the fear of pain. A few drops of blood are seen at the end of passing motion and quite often a pile mass or a skin tag is seen at the anus. Drinking plenty of water, eating vegetables and fruits will make stools soft and pain lesser. Local anesthetic ointments, sitz bath(warm water with savlon/Dettol) and laxatives help in a majority of patients. If pain doesn’t subside then a small surgery in the form of lateral sphincterotomy and gentle anal dilatation effectively gives a permanent cure to these patients. This is a day-surgery procedure.

Fissure-In-Ano

Fissure-in-Ano depicts a break in the lining of the anus due to extreme stretch during a passage of a large hard motion. Severe pain in that area will cause spasm of the anal sphincter and prevent further passage of motion causing increased constipation. This condition is often seen in girls and young women. They usually get scared going to the toilet because of the fear of pain. A few drops of blood are seen at the end of passing motion and quite often a pile mass or a skin tag is seen at the anus. Drinking plenty of water, eating vegetables and fruits will make stools soft and pain lesser. Local anesthetic ointments, sitz bath(warm water with savlon/Dettol) and laxatives help in a majority of patients. If pain doesn’t subside then a small surgery in the form of lateral sphincterotomy and gentle anal dilatation effectively gives a permanent cure to these patients. This is a day-surgery procedure.

Fistula-In-Ano

Fistula in Ano denotes a small opening/openings by the side of the anus discharging blood mixed foul-smelling pus staining the undergarments of the patient. Fistulae either result from a ruptured abscess or a surgically drained peri-anal abscess. These fistulae become painful if the outer opening gets blocked. All these fistulae will have a communication with the rectum and hence do not spontaneously close. Some fistulae are superficial called low anal fistulae and some are quite deep called high anal fistulae. Some fistulae are multiple or branched. There is no medical treatment for fistula-in-Ano. All the fistulae require surgical treatment and these are notorious for recurrence. An MR fistulogram will be necessary for complex fistulae before planning out surgery. Simple low anal fistulae can be cured by a simple surgery. Complex fistulae may require staged operations or multiple operations for a complete cure. Some of them require a seton suture. A new equipment called VAAFT (video-assisted) seems to be of promise in complex fistulae. Fistula surgery including VAAFT can be done on a day-surgery basis.

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