Anal fissure « ThePclinic

Pain In Anal Region While Passing Motions

There is pain of varying degree in the anus during passing of motions, compelling the patient to hold stool. The pain lasts for sometimes after the act. Most of the sufferers are ladies. It may follow after passing of hard stool in the recent past.

It is called Fissure-in-Ano. Non-vegetarian food of animal origin is responsible for it as that causes constipation. A life style change with more protein intake has increased it many fold. Some patients have an inherent problem of high sphincter tone. Fissure is a linear ulcer seen in the external anal region. It may occupy either front or back side of anal canal, or sometimes both the sides. In female, it is usally seen in the anterior (front) side whereas in male in the posterior side (back). Usually always, covered by a skin fold in the out side. As the skin fold guards the fissure like a sentry, called sentinel pile, is always painful to touch. The fissure sometimes bleeds and blood comes as a streak attached to the stool.

Fiber in diet prevents it. Most commonly treated in a conservative manner keeping in view to make the stool soft. So, stool softeners paly a major role. Liguid paraffin containing liquids are avoided, as they delay healing. To get ride of pain anesthetic gels are prescribed. A warm bath to anus, called sitz bath is advised after defaecation. An antibacterial gel is also advised. A smooth muscle relaxant gel is also prescribed. If conservative treatment fails a sphincter cutting surgery is contemplated. But, such surgery has the problem of anal incontenence. Most of my patients get relief from dietary modification and conservative treatment.