Anal fissures Flashcards

1
Q

Acute fissure

A

Less than 6 weeks

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2
Q

Chronic fissue

A

More than 6 weeks

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3
Q

Risk factors

A

Constipation

IBD

STIs e.g. HIV, syphilis, herpes

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4
Q

Features

A

Painful, bright red, rectal bleeding

Around 90% on posterior midline

If in alternative locations then underlying causes should be considered e.g. Crohn’s

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5
Q

Management of acute <1 week

A

Soften stool
- high-fibre diet and high fluid intake
- bulk-forming laxatives first line

Lubcricants (petroleum jelly) before defecation

Topical anaesthetics

Analgesia

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6
Q

Management of chronic anal fissure

A

Continue management of acute

Topical GTN first-line

If GTN not effective after 8 weeks secondary care referral for surgery or botulinum toxin

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