Fissure Treatment

Fissure treatment surgery is a procedure to treat an anal fissure, which is a small tear or crack in the lining of the anus. Anal fissures can cause intense pain, bleeding, and discomfort during bowel movements. They often result from hard stools, constipation, chronic diarrhea, childbirth, or other types of strain in the anal area. If lifestyle changes and medications don’t heal the fissure, surgery may be recommended to provide relief and allow the fissure to heal properly.

Types of Fissure Treatment Surgery

1. Lateral Internal Sphincterotomy (LIS):

   • Most Common Surgery: This is the most common surgical treatment for chronic anal fissures. In LIS, the surgeon cuts a small portion of the internal anal sphincter muscle to reduce tension and spasms, allowing the fissure to heal.
   • High Success Rate: LIS is highly effective, with most patients experiencing relief and healing within a few weeks.
   • Risks: There is a small risk of minor incontinence (especially for gas or mucus), but severe incontinence is rare.

2. Fissurectomy:

   • Alternative to LIS: A fissurectomy involves removing the fissure and surrounding scar tissue to encourage fresh healing.
   • Less Common: It’s generally used for chronic fissures that have not responded to other treatments or when LIS is not suitable.

3. Botox Injections:

   • Non-Surgical Option: Botox can be injected into the anal sphincter to temporarily relax the muscle, which reduces spasms and allows the fissure to heal.
   • Temporary Solution: Botox provides temporary relief, typically lasting a few months, and is sometimes used if a patient cannot undergo surgery.

4. Anal Advancement Flap:

   • For Complex Fissures: In this procedure, a flap of healthy tissue is taken from the surrounding area to cover the fissure and promote healing. This option is usually considered for complex or recurrent fissures.
   • Lower Risk of Incontinence: Often chosen when there are concerns about the risk of incontinence with LIS.

Why Fissure Surgery is Done

Surgery is generally recommended when:

• The fissure is chronic (lasting more than six weeks) and has not responded to conservative treatments like dietary adjustments, stool softeners, and topical ointments.
• Pain and discomfort significantly impact daily life.
• There is frequent recurrence of fissures, despite preventive measures.

Recovery and Life After Fissure Surgery

• Recovery Time: LIS surgery typically has a short recovery time, with most patients experiencing relief from pain and healing within a few weeks.
• Post-Surgery Care: Patients are advised to maintain a high-fiber diet, stay hydrated, and possibly take stool softeners to avoid straining during bowel movements.
• Success Rates: Lateral internal sphincterotomy (LIS) has a high success rate, with most patients achieving lasting relief and minimal recurrence of fissures.

Fissure treatment surgery generally provides effective and long-term relief for chronic fissures, allowing people to return to normal activities and significantly reduce pain and discomfort.