PAINFUL ANORECTAL CONDITION
Anal Fissure
A small but intensely painful tear in the lining of the anus, causing sharp pain and bleeding with every bowel movement. Dr. Samhitha Reddy provides the best fissure treatment, from conservative management to laser sphincterotomy.
ABOUT THIS CONDITION
What is Anal Fissure?
An anal fissure is a small crack or tear in the thin moist lining of the anus. Despite being small, it causes disproportionately intense pain, often described as passing broken glass, due to the rich nerve supply in the anorectal region. Acute fissures (less than 6 weeks) frequently heal with conservative treatment. Chronic fissures (more than 6 weeks) typically require a procedural or surgical intervention. Fissure treatment encompasses the full clinical pathway: topical medical therapy, Botox injection for sphincter relaxation, Lateral Internal Sphincterotomy (LIS), Fissurectomy, and Advancement Flap repair for selected chronic cases, all performed by Dr. Samhitha Reddy, one of the best fissure doctors.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Hard or large stools tearing the anal lining
- Chronic constipation and repeated straining
- Diarrhoea, repeated loose stools irritating the mucosa
- Childbirth trauma, especially posterior midline tears
- Reduced blood flow to the anorectal region
- Crohn's disease or other inflammatory bowel conditions
CLINICAL DETAILS
KeyFacts
Acute (<6 weeks): topical therapy. Chronic (>6 weeks): LIS, fissurectomy, or flap repair
Gold-standard surgery, small cut in internal sphincter relieves spasm and promotes healing
Excision of fibrotic fissure tissue, often combined with LIS for chronic disease
Selected chronic fissures where sphincter surgery is contraindicated, flap anoplasty covers the defect
Return to work in 24-48 hours post-LIS. Complete healing in 4-6 weeks
Covered by most major health insurance policies at Lux Hospitals, Hyderabad
HOW WE TREAT IT
Treatment Approach
From Topical Therapy to Surgical Repair, Complete Fissure Care
Anal fissure treatment covers every stage of the disease. Acute fissures are treated with dietary modification, topical GTN or diltiazem cream, and sitz baths. Chronic fissures unresponsive to medical therapy are managed with Botox injection, Lateral Internal Sphincterotomy (LIS), or Fissurectomy. Selected cases with sphincter contraindications receive Advancement Flap / Anoplasty.
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Assessment, Acute vs Chronic
Dr. Samhitha examines the fissure and determines acute or chronic status. Investigations assess for underlying sphincter spasm and rule out Crohn's disease in atypical presentations.
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Conservative Treatment (Acute Fissures)
High-fibre diet, adequate hydration, sitz baths, stool softeners, and topical anaesthetic or nitrate/calcium channel blocker (GTN/diltiazem) cream. Heals most acute fissures within 4-6 weeks.
- 3
Lateral Internal Sphincterotomy (LIS)
The gold-standard surgical treatment for chronic anal fissure, a small, precisely controlled incision in the internal anal sphincter relieves spasm, restores blood flow, and allows the fissure to heal. Short day-care procedure.
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Fissurectomy & Advancement Flap
Fissurectomy excises the fibrotic chronic fissure tissue and is often combined with LIS. For selected cases where sphincter surgery is contraindicated, Advancement Flap / Anoplasty is used to close the defect with healthy tissue.
AVAILABLE TREATMENTS
Treatment Options
Lateral Internal Sphincterotomy (LIS)
Partial division of the internal anal sphincter to reduce resting pressure, improve blood flow, and facilitate healing of chronic fissures.
Fissurectomy
Excision of fibrotic fissure edges and associated sentinel tags to convert a chronic fissure into an acute wound for better healing.
Advancement Flap / Anoplasty
Reconstruction using adjacent healthy tissue to cover the fissure defect, particularly in chronic or recurrent cases with poor healing.
COMMON QUESTIONS
Frequently Asked
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