Tearing and abrasion tear, scratches and cracks and sores in the anal fissure or Fisher said. The rupture caused by spasm (contraction) of internal anal sphincter and cause pain and increase the depth of the rupture is severe wounds caused by reduced blood supply to the anus.
Prevalence: From infancy to old age are generally very common.
Causes: Constipation and diarrhea often prolonged and excessive straining during defecation and childbirth streining and is caused by prolonged use of laxatives.
Sometimes, due to increased pressure in the anal canal (pressure) system Asfnktryk (bowel control) is high, resulting in impaired blood supply to the skin is Vmkhat anal fissure is created.
· Psychological disorders also increase Tvnvsyth Asfnktryk systems and sometimes because the fissure.
Unknown Causes: Sometimes, however, the cause is not clear fissure.
Symptoms: The main symptoms are pain and bleeding anus.
Pain is the most important diagnostic fissure pain is worse off in the course of successive Venice is cyclical and recurrent pain and pain in a severe and prolonged period is to be constant. Under the curve of pain in mind. Due to severe pain in patients with possible passage of stool withholding and constipation Tshdydh and therefore it causes more severe wounds and a vicious cycle is created. If the first 6-3 weeks is a pain if it is more acute fissure and fissure it is called chronic fissure is chronic, often around a leading edge.
Acute fissures usually treated with medical therapy, but chronic fissures, often requiring surgery (laser or standard) is.
After passing bright red blood at the time of disposal or other signs of a fissure. With black stools (melena) have other reasons to be searched.
Purulent discharge can be caused due to secondary infection fissure.
Sometimes the raised border of the small bowel fistula fissure is purulent discharge.
· Anal itching sometimes occurs, but it is not necessary for diagnosis.
Sometimes hemorrhoids (hemorrhoids), fissures exist simultaneously and together they give a reason for the surgery (laser standard), acute fissure is even.
· Fissure itself is not carcinogenic, but especially in the top 40 at the same time there must be considered.
Medical treatment: acute fissure and fissure in 50% of cases of chronic drug therapy improves liver in 10% of cases. Chronic fissure, acute fissure treatment in general medical and surgical treatment is preferred.
Fissure has several important principles: treating constipation - pain - hot tub
Drug treatment of fissure-fiber diet with plenty of water and exercise more (exercise more) and get treatment if necessary, use of laxatives.
Pain with anti-inflammatories such as cortisone creams contain anesthetics Zaylvkayyn property relief will be given at the time of disposal.
Suppositories are often useless because the bowel (rectum) while the denominator is placed on denominators are the scars.
Pain associated with chronic anal fissures ointment 2/0% Nitrate (as glyceriltrinitrate) or oral or topical diltiazem 2% or Ayzvsvr Dylytazm should be treated with nitrates. Recently, the use of arginine and Btankvl has also been suggested.
The form nitro ointment anal fissure But from the Nytrvgylysryn Gylysryn market is 3% 3/0 is used, however, to a concentration of 5% / 0% is used. This day cream in the morning and two in the afternoon and evenings for up to 8-10 weeks is used and can not be used as a contraction of the sphincter at night and sleep decreases. The ointment, especially at higher concentrations can cause headaches like Astamynvfyn be controlled with painkillers.
The headache is less and the Diltiazem is preferred.
Bvtvlynvyvm Toxin (botox) botalinium fissure also be used if the patient is resistant to medical therapy and topical ointment glyceriltrinitrate and diltiazem, and surgery is not possible or the patient is not satisfied that it is used.
10-2/5 internal sphincter at the sides of the unit for anesthesia and hospitalization are Shvdvnyaz denred lin injections. Because this drug is quite expensive and only in cases where glyceriltrinitrate diltiazem and other medical procedures that are not effective.
Nyfdpyn ointment 2/0% and Btankvl the fissure has been used, but their efficacy needs further investigation.
Warm sitz bath tub of warm water.
Asfnktryk system will help to reduce the activity of water, 40 ° C for 20 minutes, 3 times a day.
Do Btldyn and permanganate or salt in it.
The most effective treatment for chronic anal fissures cut the internal sphincter and its success rate is 100 to 95%.
Generally when Fisher pain despite medical therapy for one month stay or will recur after initial recovery operation is attempted. In case of severe pain, surgery decisions faster.
Local anesthesia in surgery and outpatient surgeries standard methods or by using a laser to cut the internal sphincter in other areas will also be removed sentinel pile or skin tag. Using a long-acting anesthetic to the patient can immediately go to work. Most patients experienced improvement in pain immediately, but a few days later the pain from the incision, especially in passing that the housing can be controlled.
Instructions after surgery:
1 - high-fiber diet
2 - no straining
3 - Use of laxatives if necessary
4 - Housing
5 - Antibiotics
6 - Use warm water basin containing dilute Betadine for 10 days
7 - Driving and walking and bathing is permitted.