Anal Fissure Flashcards
1
Q
Anal Fissure
A
Anal Fissure = longitudinal or elliptical tear of squamous lining of distal anal canal
<6w = ACUTE >6w = CHRONIC
Acute: <6w
- Dietary advice, high fibre, high fluid intake
- Bulk forming laxatives
- Lubricants pre defecation eg petroleum jelly
- Topical anaesthetics
NB: Around 90% of anal fissures occur on posterior midline
Chronic >6w:
- Continue above techniques
- TOPICAL GTN - 1st line Mx of chronic anal fissure
- If topical GTN is not effective after 8w then secondary referral should be considered for either surgery or botulinum toxin
NB Topical steroids DO NOT provide relief