Treatment of anal fissures in Ternopil 

Anal fissures require consultation with a colorectal surgeon. Having arisen once acutely, with improper treatment, they usually recur and turn into a chronic form that is poorly treated conservatively. Its symptoms cause a lot of suffering and make life difficult through acute pain, bleeding from the anus, fear of defecation, defecation problems, physical and psychological discomfort.

Treatment of chronic forms, as a rule, is surgical, as they are excised. Modern colorectal surgery (proctology) offers several minimally invasive techniques that allow to effectively perform a surgery of any degree of complexity without pain and blood loss. 

All possible methods are available in the colorectal surgery department of Viasan Medical Centre.

What is a fissure in the anus

This is a linear defect of the mucous membrane of the anus in the area of its connection with the internal sphincter, a circular smooth muscle involved in the act of defecation. The crack of the anus (fissure) can be of different length and shape (long, rectangular, elliptical).

By the nature of their course, cracks can be:

1. Acute. They appear unexpectedly, usually after problematic defecation. In half of the cases, they heal on their own. Symptoms:

• cutting, sharp pain during or after defecation;

• spasm of the anal sphincter;

• bleeding from the anus (sometimes heavy).

2. In other cases (fissures that do not heal within a month) cracks turn into a chronic form. It is characterized by signs of a chronic process:

• raised callose edges;

• sentinel polyp;

• exposed sphincter muscles;

• hypertrophied anal fringe;

• periods of absence of pain and discomfort.

By localization:

• posterior (back) - cracks are located on the back of the anus;

• anterior (front) - cracks are located on the front;

• side (mirror) - cracks are located symmetrically.

Symptoms:

• sharp pain during or after defecation;

• itching in the anus;

• bloody discharge from the anus;

• pain during a forced position;

• fear of defecation (in chronic form).

Reasons:

• acute and chronic constipation;

• mechanical injuries of the anus;

• haemorrhoidal disease;

• pathologies of the digestive tract;

• violation of blood circulation in the rectal area;

• low physical activity, overweight;

• irrational nutrition.

Methods of treatment

Acute, uncomplicated forms of cracks (smooth edges, clean bottom) are usually treated medically. The patient is prescribed warm baths, rectal ointments, suppositories, oil enemas. Diet is a key point in establishing bowel function.

If such measures are ineffective, medication therapy is supplemented with a blockade with divulsion (mechanical stretching) of the anus, which makes it possible to temporarily relieve muscle spasm. On average, it takes 2-3 blockades and three weeks of conservative treatment for the crack to heal. If this does not happen, a surgery is prescribed, which consists of excision of the defective mucous membrane of the anus in a single unit, including anal fringeі and sentinel tubercles, if they are present.

How is the surgery performed?

The defect of the anus mucous membrane can be eliminated both by a classical surgical method (scalpel) and by means of alternative minimally invasive technologies (excision with radio waves, laser, ultrasound).

Classic surgery has its pros and cons:

• is simple to perform, does not require specialized equipment;

• requires hospitalization for at least 10 days;

• the need for long-term analgesia;

• a longer recovery period;

• possible formation of keloid scars;

Therefore, colorectal surgeons are increasingly resorting to more gentle techniques. The scalpel is replaced by a laser beam, radio knife, and ultrasound, capable of cutting out necrotic tissues without damaging healthy ones, simultaneously sealing blood vessels, and preventing the development of scar tissue. 

Advantages of scalpel-free surgery:

• lack of need for long-term anaesthesia;

• minimal tissue injury, no swelling;

• short recovery period;

• elimination of the anal canal deformation;

• preserving the function of the anus in defecation.

Treatment of anal fissures in Viasan

• Modern protocols of conservative therapy.

• The possibility of surgery using classical and minimally invasive techniques.

• Qualified specialists, the latest equipment.