Dr. Nitish Jhawar is answering questions related to Anal Fissure in Times of India
Q1. I am 26 yrs old sales executive I had severe constipation after my travel last week ,now feeling severe pain while passing stool and noticed some bleeding also on the tissue while cleaning is it piles ?
A. Most commonly piles cause painless bleeding so if it’s a classical cutting glass pain following defecation with smudging on the tissue or a streak of blood on a stool then it may be Fissure – in – Ano. A simple visit to your surgeon will solve your problem.
Q2. Do fissures always require surgery?
A. The mainstay of treatment is medical which is aimed at reducing the pain, relaxing the anal muscles & curing the constipation surgery can be avoided in many cases.
Q3. If medical treatment fails then is there any other remedy other than conventional surgery?
A. Fissures refuse to heal due to spasm of the sphincter muscle if medical treatment fails then we can actually temporarily paralyze the internal sphincter muscle by injecting BOTOX. It is safe, fast and convenient but fissures may relapse once the muscle gains their normal tone again.
Q4. What is the conventional surgery all about will I lose control over my feces after getting it done?
A. Standard treatment for a fissure is called LIS (Lateral Internal Sphincterotomy) with or without fissure ectomy (excision of the fissure) it comprises of loosening the internal muscle by cutting a part of it. It is the very controlled way of releasing the spasm and there is no long-term effect on the continence.
Q5. Can LASER be done to cure fissures?
A. Yes LASER can be used to treat the fissures it’s a little expensive option but the equally good option as an LIS.
Q6. I recently delivered a baby and now having a painful bleeding from rectum since last 2 weeks do I need surgery as it is difficult to take care of by newborn with this painful condition?
A. It is very common to have fissure problem during or after delivery, medical treatment mostly helps and surgery is required only in nonresponsive cases.
Q7. I am a 40-year-old man I noticed some painful bleeding recently. I looked up on the internet I am scared that it could be Cancer please help?
A. The bleeding from the rectum can very well be a sign of cancer if associated with any of the RED flag signs like weight loss, change in bowel habits, black or tarry stools, anemia, family history of colorectal cancer etc. A short duration fresh bleed is usually not so ominous but visits to a specialist are required to rule out any lurking danger avoid self-medication at all cost.