Anal Fissur

Question 1

What is anal fissure

Answer 1

An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement.

Question 2

Clinical features of anal fissure

Answer 2

• Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter).

Presenting complaints
*Tear in the anus
*Pain-and bleeding during defecation Unable to pass stool because of anal pain

Question 3

Causes of anal fissure

Answer 3

*Passage of hard stool Diarrhea
*Trauma
*Anal sex/ STD
*Tuberculosis
*Surgery e.g. post haemorrhoidectomy

Question 4

Treatment of anal fissure general measures

Answer 4

general measures
*Adequate fluid intake
*High fiber diet
*Bulk laxatives
*Stool softener (lactulose) Use of *xylocain gel
*Sitz bath
*Regular anal dilation

Question 5

Definite measures of treatment 2

Answer 5

*Tropical nitroglycerin 0.2%
*Botulinum toxin 25unit
*Diltiazem 2%
*Lord’s anal dilation
*Dorsal fissurectomy with sphincterostomy Lateralanal sphincterostomy.

Question 6

Complication oftreatment

Answer 6

*Incontinence
*Retention of urine - Post Op pain
*Hemorrhage
*Infection

Question 7

Differential diagnosis of anal fissure

Answer 7

*Cancer of the anal canal STD
*TB ulcer
*Anal chancre Ulcerative colitis Crohn’s disease
*Proctalgia fulgax