Anal fissures

Question 1

what is an anal fissure

Answer 1

tear or ulcer in anal canal, within anal margin

Question 2

symptoms of fissure

Answer 2

1) bleeding (bright red blood)
2) persistent pain on defectation
3) linear split in anal mucosa

Question 3

acute fissure <6 weeks tx

Answer 3

1) laxative bulk forming alt; osmotic
2) topical treatment aesthetic i.e lidocaine apply before emptying bowel

Question 4

chronic fissure >6weeks

Answer 4

GTN ointment (s/e H/a)
alt - oral or topical (preferred) diltiazem or nifedipinine