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An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. If acute they are painful after defecation , [ 1 ] but with chronic fissures, pain intensity often reduces and becomes cyclical.
Generally, fissures are due to injury to the mucosa, or because of a poor local blood supply that prevents proper healing, with spasm of the external anal sphincter contributing. [9] The external anal sphincter can be relaxed by the application of glyceryl trinitrate creams, and constipation is managed with laxatives and improving hydration. [ 9 ]
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Anal fistula is a chronic abnormal communication between the anal canal and the perianal skin. [1] An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. [2] Anal fistulae commonly occur in people with a history of anal abscesses. They can form when ...
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Lateral internal sphincterotomy is the preferred method of surgery for persons with chronic anal fissures, and is generally used when medical therapy has failed. [1] It is associated with a lower rate of side effects than older techniques such as posterior internal sphincterotomy and anoplasty, [3] and has also been shown to be superior to topical glyceryl trinitrate (GTN 0.2% ointment) in ...