Anal Fissure (Anus Crack)
A crack in the anus is called anal fissure. It reaches the dentate line from the skin (mucocutaneous junction). There are two types, acute or chronic. Acute fissure can be relieved without medication or with medication. Chronic fissures are non-healing fissures despite 4-6 weeks of treatment.
It is frequently observed in young-middle-aged adults but may also occur in all age groups. It is observed at a similar rate in women and men. In men, it is mostly in the direction of 12 o’clock on the side of the sacrococcygeal articulation, and its in the direction of 6 o’clock in 1%. In women, it is mostly in the direction of 12 o’clock and rarely in the direction of 6 o’clock. A very small proportion also appears on the side walls.
The reasons for the exact appearance are unknown;
- Chronic constipation or diarrhea
- To have a breech surgery
- Anatomical or genetic predisposition
- Stress can be counted as the causes of fissures.
The cause of chronicity is fissure caused by sphincter pressure (ischemia). Pain in the anus canal and its induced contraction (spasm) lead to chronic ischemia fissure in the square after contraction. In anal fissures, the skin-tag in the anal canal exit, the hypertropic papillae in the canal and the depth of the fissure base occur after the efforts to improve the fracture.
Delayed treatment may include abscess and fistula in the fissure base. reveal complicated table. Pain and bleeding are the primary symptoms. During defecation, the pain begins and shows a long period of time. Fissures are the main cause of rectal bleeding in children. Diagnosis is made by examination. Anaskopla examination can be preferred. Inflammatory bowel diseases (crohn, ulcerative colitis), syphilis (syphilis), anal cancer, AIDS, anal abscess should be considered in the differential diagnosis.
Relaxing pomades, puffs with local anesthetics, diet change, food consumption, correction of defecation habits (avoiding the elusive running), warm water sitting bath is beneficial. Some local drugs that have been developed have recently been preferred in the treatment of acute anal fissures. Isosorbit dinitrate pomades are applied around 3 days per day and to the base of the fissure. Reduces pain. There are few curative aspects. Diltizem Pomat: It is applied to the painful area. It has limited curative effect.
Lateral internal sphincterotomy is the main treatment modality. When applied, the contraction in the anal canal is relaxed, the fracture heals. The experience of experienced surgeons in anal surgery increases the success rate. A great deal of success is achieved. Medical treatment is preferred for children. Different treatment options are less preferred.