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Anal fissure: treatment
Last reviewed: 23.04.2024
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Conservative treatment of an anal fissure in an acute period provides, first of all, elimination of pain syndrome, spasm of the sphincter and normalization of the stool. A diet with restriction of acute and irritating dishes is recommended. Once a day, a cleansing enema is prescribed from boiled water at room temperature in a volume of 1 liter.
The tip is densely lubricated with vaseline oil, injected along the edge of the anal opening, opposite to where the crack is located. Independent chair during this period should be avoided because of the danger of exacerbation of pain and increased spasm of the sphincter. Laxatives are contraindicated, as they can exacerbate pain. After cleansing the intestine - warm (38 ° C) sedentary bath with a weak solution of manganese for 10 minutes. The area of the anus is dried with gauze or cotton wool, then a suppository with the following composition is introduced into the rectum: Extr. Belladonnae 0.015; Eroformi 0.1; Novocaini 0.12; But. Cacao 1.7. Before going to bed, another bath should be taken, rectally the suppository of the same composition is administered. The described course of treatment is continued until complete fracture epithelialization (usually from 4 to 6 weeks). Enema is usually put during the first 10 days from the onset of the disease, in the future the chair is independent. To interrupt the pain syndrome and to influence the reparative processes, such treatment methods as presacral novocain blockades with a 0.25% solution according to Vishnevsky, injections under the crack of alcohol-kovine solutions, an oil-anesthetic solution, hydrocortisone and novocaine are recommended. The most common were injections under the crack of hydrocortisone (25-50 mg in 3-4 ml of 0.5-1% solution of novocaine).
When conservative treatment of an anal fissure is ineffective, resort to a surgical intervention, which consists in excision of a crack and sphincterotomy. During the operation, the hemorrhoids are also excised. In recent years, a closed lateral subcutaneous sphincterotomy is proposed to treat the uncomplicated anal fissure. The results show that after it pain disappears more quickly and relapses are less.
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