ANAL FISSURE

Dear Doctor,

I am 27 years old male, suffering from anal fissure for past one year. I have undergone number of treatments. My fissures did not responds to the treatments:

Symptoms: Anal itching, burning, and occasionally mild pain.

Visual Inspection: I have many small tears with sentinel pile / skin tags in the skin of the anal canal at different positions.

History of treatments I have undergone:
A)      Non-surgical treatment: Proctosedyl, lidocaine, xylocaine ,  hydrocortisone  .All these topical ointments I have tried with warm sitz baths,  high-fiber diet , stool softeners and antibiotic tablets in one year)..They helps in reducing the symptoms, but never healed the fissures.
B)      surgical treatment: Anal dilation (Lord's Operation): 10 months before. It healed a big fissure at 6 O'clock position, but did not heal the small fissures.
C)      2 % Diltiazem (for Chemical sphincterotomy ): currently using it form last month..it also did not respond to fissures.

I do not have any other medical problems..I feel quite healthy, except I have to spend long time in toilet for cleaning of anus.
I want a complete removal of these things. .Please suggest me best option to treat anal fissures.

[Ratnakar Kini, MD]

Hi,
Lateral internal sphincterotomy is the most effective treatment for anal fissures.