Do fissures require surgery?

An Overview About Anal Fissures

An anal fissure is a condition where there is a minor tear in the mucous anal linings that can cause pain and even blood discharge. The lining is thin and moist and easily susceptible to such damages and may require treatment depending on the intensity. Although most people tend to put off treatment due to a high anal fissure surgery cost or inconvenient procedures, doctors recommend that the treatment be administered with occasional medication and may even require surgery. 

These fissures occur when a hard bowel movement causes bleeding and pain in the rectum area. The pain can also trigger spasms in the muscles in the anal region, commonly known as the sphincter muscles. Although the problem is widespread with young infants, people of all ages experience such types of fissures at some point or the other.

Causes of Anal Fissures

  • Common causes are mostly the passing of large or hard stools that may cause a tear in the linings of the inner anal region. 
  • It also occurs due to constipation and strain in the anal region that may occur during bowel movements. 
  • Another factor may be chronic diarrhoea that is usually prevalent in older people. 
  • It occurs due to sexual activities that may involve the anal region during intercourse. 
  • During or after childbirth in women as the entire pelvic region tends to expand and stretch.
  • Diseases that are sexually transmitted or otherwise like HIV, Syphilis, Crohn’s disease or even anal cancer.

Symptoms Related To Anal Fissures

  • Chronic and severe pain associated with bowel movements varies in intensity, sometimes mild and sometimes severe.
  • Severe pain after bowel movements may last from a few minutes to several hours. 
  • Burning sensations and even itching tendencies may be related to anal fissures.
  • The presence of blood on stools or in the toilet after a bowel movement can signify damage. 
  • Cracks on the skin surrounding the anus is a visual indication of a fissure.

The presence of a minor skin protrusion, commonly known as a tag or a lump in the area around the anus, is an indication of a possible tear.

Anal Fissure Treatment And Surgery. What To Choose?

In most patients who underwent diagnosis, anal fissures heal independently within four to six weeks or even two months. Chronic symptoms are considered beyond that period where the fissures persist beyond that time.

Many home remedies are recommended to treat the problem and alleviate the discomfort that occurs with it. Eating a specific gram of fibres every day can make the stools softer and be soft enough to encourage the healing of the anal tissues. One can increase fibre intake by opting for food such as fruits and vegetables rich in natural fibre. Nuts and whole grains are also fibre rich, although it is recommended for the gradual increase in intake as adding fibre instantly can cause bloating.

Drinking adequate fluids, especially those containing stool softeners, is also recommended as it helps prevent constipation. Keep in mind not to strain too much as an open scar during its healing process or give rise to a new year.

When To Get A Surgery?

Sometimes, the fissures won’t heal and may stay open long enough to cause continuous pain. This chronic symptom can only be treated through surgical methods as keeping the fissures untreated can cause future complications. Look at the following points to know when to get surgical treatment:

When the wound fails to heal, consider surgery. Eight weeks is the standard optimum time recommended for fissure wounds to heal. Any time beyond that is a sure indication that surgical treatment is compulsory for healing.

Once an anal fissure heals, patients, especially older ones, are prone to relapse, meaning that they would have another fissure again in the future. In such cases, constant recurrence will occur without surgical treatment and make it difficult for the patient.

Surgical treatment is also advised for unhealed fissure rounds that can be deep enough to expose tissues of muscles underneath it. This tear can also get wide enough to extend into the anal sphincter muscles and make it more difficult for the fissure to heal fully. Unhealed fissures can cause more discomfort to the patient. Instead of backing off due to anal fissure surgery cost, consider surgery to repair or even remove it and alleviate the pain and inconvenience.

Stool softeners and medications may be recommended after surgery to improve the fissure wound healing odds and reduce the tendency of the anal fissures to occur again and cause relapse.

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