Anal fissures Flashcards
1
Q
Acute fissure
A
Less than 6 weeks
2
Q
Chronic fissure
A
More than 6 weeks
3
Q
Risk factors
A
Constipation
IBD
STIs e.g. HIV, syphilis, herpes
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
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
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
