PakMediNet Discussion Forum : Surgery : Rx of fissure
Rx of fissurecan anyone help me regaring rx of fissure othr than surgery.my cousin has got this prob.wat othr measures cn b done for.sme cud help.
Posted by: mskhanPosts: 7 :: 18-04-2008 :: | Reply to this Message
Re: Rx of fissure
First-line medical therapy consists of therapy with stool-bulking agents, such as fiber supplementation and stool softeners. Laxatives are used as needed to maintain regular bowel movements. Mineral oil may be added to facilitate passage of stool without as much stretching or abrasion of the anal mucosa, but it is not recommended for indefinite use. Sitz baths after bowel movements and as needed provide significant symptomatic relief because they relieve some of the painful internal sphincter muscle spasm. Recurrence rates range from 30-70% if the high-fiber diet is abandoned after the fissure is healed. This rate can be reduced to 15-20% if patients remain on a high-fiber diet.
Second-line medical therapy is the topical application of 0.2% nitroglycerin (NTG) ointment directly to the internal sphincter. Some physicians use NTG ointment as initial therapy in conjunction with fiber and stool softeners, and others prefer to add it to the medical regimen if fiber and stool softeners alone fail to heal the fissure. NTG ointment is thought to relax the internal sphincter and to help relieve some of the pain associated with sphincter spasm; it also is thought to increase blood flow to the anal mucosa.
Source: Visit this link: http://www.emedicine.com/med/TOPIC3532.HTM
Posted by: imtiazkPosts: 56 :: 19-04-2008 :: | Reply to this Message
Re: Re: Rx of fissure
thanx for ur concern
for chronic anal fissur of more than a yr is gtn ointment good.?isnt there any permanent cure for this.?again xcept surgery.
Posted by: mskhanPosts: 7 :: 19-04-2008 :: | Reply to this Message
Re: Rx of fissure
think of four finger anal dilatation in case of chronic anal fissure.
may work or not.
but has to be in spinal/ GA
Posted by: shami1978Posts: 12 :: 24-06-2009 :: | Reply to this Message
Re: Rx of fissure
Treatment for chronic and recurrent(hence qualify for the term chronic.) anal fissure is nothing but surgery....
MDA is obsolete due to excessive damage likely to be incurred on internal sphincter as amount of stretch by surgeons finger can't be controlled and may result in over tearing of sphincter fibers. Lateral internal sphincterotomy is treatment of choice for fissures.
EVen for acute fissures if they don't respond to medical treatment initially, but still can't be labelled as chronic, treatment will remain surgery.
Posted by: drfarhanPosts: 93 :: 25-06-2009 :: | Reply to this Message