An observational study comparing and non-surgical treatment with surgical treatment for chronic anal fissures

Authors

  • Anupam Banerjee Assistant Professor, Department of General Surgery, Calcutta National Medical College, Kolkata, West Bengal, India https://orcid.org/0000-0003-1905-4132
  • Pinaki Roy Assistant Professor, Department of General Surgery, Calcutta National Medical College, Kolkata, West Bengal, India https://orcid.org/0000-0001-7655-2539
  • Rajat Suvra Moral Associate Professor, Department of General Surgery, Calcutta National Medical College, Kolkata, West Bengal, India
  • Swarup Chakraborty Associate Professor, Department of General Surgery, Calcutta National Medical College, Kolkata, West Bengal, India https://orcid.org/0000-0002-7985-4548

DOI:

https://doi.org/10.3126/ajms.v14i1.46879

Keywords:

Anal fissure; Anal sphincterotomy; Botulinum; Fissure in ano

Abstract

Background: Chronic anal fissure is a common benign anorectal condition that causes significant morbidity. Symptoms consist primarily of pain and bleeding during defecation. Fissures are predominantly located in the posterior midline, but 25% of women and 8% of men have anterior fissures.

Aims and Objectives: The aim of the study is to determine the outcome of various nonsurgical therapy for chronic anal fissure and comparison with the outcome of surgical treatment.

Materials and Methods: This study was a non-randomized and observational study. All patients referred to the department of general surgery between December 2012 and November 2014 for a chronic anal fissure were included in the study, above the age of 12 years, and diagnosed to have anal fissure (Both Acute and Chronic) were included in the study.

Results: Seventy-nine patients (91.9%) were having symptoms of pain; this pain was persistent for hours after defecation in 67 (78%) patients. Seventy-one (82.6%) patients complained of at least one episode of bleeding per Anum, other symptoms were perianal lump (10.5%), perianal itching (23.3%), and perianal discharge (30.2%). The examination findings of these patients revealed that 81 patients (94%) had developed sentinelpiles subsequently and anal fissure with visible fibers of underlying muscle were seen in 9 (10.5%) patients.

Conclusion: Chronic anal fissures can be simply and effectively treated medically without the risk of incontinence associated with sphincterotomy. Topical nifedipine and botulinum toxin injections are an excellent combination, associated with a low recurrence rate and minimal side effects.

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Published

2023-01-01

How to Cite

Anupam Banerjee, Roy, P. ., Moral, R. S., & Chakraborty, S. (2023). An observational study comparing and non-surgical treatment with surgical treatment for chronic anal fissures. Asian Journal of Medical Sciences, 14(1), 222–225. https://doi.org/10.3126/ajms.v14i1.46879

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Original Articles