FISSURE IN ANO (ANAL FISSURE):
Anal fissures are a natural crack or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, sometimes in the toilet. If acute they may cause severe periodic pain after defecation but with chronic fissures pain intensity is often less. Anal fissures usually extend from the anal opening and are usually located posteriorly in the midline, probably because of the relatively unsupported nature of the anal wall in that location. Fissure depth may be superficial or sometimes down to the underlying sphincter muscle. Common people call it Badi Bawaseer or Gudhacheer.
- Pain in Anal area, which increases after passing stool.
- Agonizing pain, patient prefers to remain constipated rather than going through the agony.
- Bleeding- stools are streaked with blood.
- Constipation – pain is either initiated or aggravated with the passing stool, tendency to defer going to stool, so constipation.
- Burning sensation at the anal opening.
- Swelling – A large sentinel tag cause painful external swelling.
- Urinary symptoms – some patients may develop retention, dysuria or increased frequency.
SMART TIPS TO HELP RELIEF FROM PAIN:
Warm water sitz bath (sitting in a tub containing warm water).
A suitable dose of analgesic consumed half an hour before going for defecation gives a good amount of relief in post defecation pain.
Plenty of oral fluids help in keeping the stools soft. High-fiber-diet like green leafy vegetables and fibrous fruits plus bulk-forming agents such as Isaphgula, gum karaya or osmotic laxatives like lactulose go lead to a smooth and swift act of defecation.
Maintain a regular bowel habit.Application of local anesthetic cream or gel. Ointments containing opiates, xylocain, amethocain, and cinchocain.
These mixtures are introduced on the finger or through a short rectal bogie to ensure a thorough application over the affected part of the anus. The best practice is to insert the ointment over an anal dilator, which also helps relieve the sphincter spasm.