Anal Fissure – an extensive update

Salati, Sajad Ahmad

doi:10.5604/01.3001.0014.7879

Cited by 13 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Acute anal fissures last shorter than six weeks. They are superficial, limited to anoderm, and have sharp, fresh mucosal margins with granulation tissue at the base [5]. Chronic anal fissures (CAF) are characterized as resistant to medical treatment after six weeks.…”

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial

Shahid¹,

Javed²,

Javed³

et al. 2022

Cureus

View full text Add to dashboard Cite

Background and objectiveAn anal fissure is a longitudinal, oval lesion in the anal canal. In over 90% of instances, the anal fissures are located posterior to the midline and produce discomfort upon defecation and/or bleeding owing to spasms of the internal anal sphincter that leads to ischemia. This research aimed to determine if topical metronidazole treatment when combined with glyceryl trinitrate 0.2% (GTN), is more successful than GTN alone in reducing the time for an acute anal fissure to heal. Material and methodsThis study was a single-blinded, randomized controlled trial conducted at the DHQ Hospital Okara from January 2022 to August 2022. Patients of both genders, aged 18 to 70 years, with acute anal fissures, were included. One hundred forty patients who satisfied the inclusion criteria were randomized through the lottery technique and were divided into two groups (70 in each group). Group A contained patients who got metronidazole combination with GTN, while in Group B, patients treated with GTN alone without metronidazole. The primary endpoint was fissure healing, confirmed as finding a scar where the fissure was. While the secondary endpoint was maximum pain on defecation assessed by the Visual Analogue Scale (VAS). Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) v24. Chi-Square and Fisher's Exact tests were done for statistical analysis, and p < 0.05 was considered significant. ResultsThree patients lost the follow-up. Out of the remaining 137, 70 (51.1%) patients were male. The patient's ages ranged from 22 to 68 years, with a mean age of 39.18 ± 11.52. One hundred twenty six (92%) complained of pain on defecation with a mean VAS of 6.01 ± 2.35. 80 (58.4%) patients complained of perianal itching, while 25 (18.2%) patients complained of bleeding on defecation.On week 1 follow-up, in group A out of 69 patients, 27 (39.1%) had complete healing, 38 (55.1%) had partial healing, while in group B out of 68 patients, one (1.4%) had complete healing, 43 (63.2%) had partial healing (p = < 0.001, significant).On week 3 follow-up, in group A out of 69 patients, 47 (68.1%) had complete healing, and 22 (31.8%) had partial healing, while in group B out of 68 patients, 16 (23.5%) had complete healing, 49 (72%) had partial healing (p = < 0.001, significant). Mean VAS score of group A was 0.61 ± 1.38 while that of group B was 2.57 ± 2.50 (p = < 0.001, significant). ConclusionUsing topical metronidazole as an addition to standard therapy may reduce the chronicity of acute anal fissures and prevent surgical treatments with high rates of complications.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial

Shahid¹,

Javed²,

Javed³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…It is well known that bleeding, wound infection, and abscesses are considered general complications following every operation [ 12 ]. Incontinence to gas and stool has emerged as a major concern after sphincterotomy [ 1 ]. Incontinence rates of up to 14% have been reported, but these vary widely among studies [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Much of this variation can be attributed to differences in definition and assiduousness of follow-up. Incontinence is the main complication feared by most surgeons [ 1 ]. We think that an accurate operation with a correct indication of surgery should avoid this problem.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Lateral Internal Anal Sphincterotomy of Chronic Anal Fissure: An Experience of 165 Cases

AL-Ubaide¹,

Al-Rubaye²,

Al-Ani³

2022

Cureus

View full text Add to dashboard Cite

Background: The anal fissure is frequently seen in surgical practice. It is caused by a longitudinal tear in the anoderm distal to the dentate line. The hallmark feature of the disease is severe pain during defecation. Chronic anal fissure (CAF) causes undue stress that leads to poor quality of life. Different options of treatment, whether medical or surgical, are employed to treat this condition. One of these modalities is lateral internal anal sphincterotomy (LIAS).Objectives: We aimed to assess the safety and efficacy of the LIAS surgical procedure for the treatment of CAF.

show abstract

“…Patients usually present with moderate to severe anal pain, described as "like passing broken glass," aggravated by defecation, and lasts several minutes to hours afterward [9]. Although bleeding occurs less commonly in anal fissures than hemorrhoidal diseases, patients may notice a small amount of bright-red blood on the toilet paper resulting from chronic ulceration in the epithelium (Figure 2).…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

Sphincterotomy is the Gold-Standard Treatment of Chronic Anal Fissure: But How Should it be Done?

Balci¹,

Leventoğlu²,

Menteş³

2023

Benign Anorectal Disorders - An Update

View full text Add to dashboard Cite

A chronic anal fissure is one of the most encountered anorectal diseases in the clinical practice of general surgery. After all the medical therapies have failed, lateral internal sphincterotomy is still the main-stay treatment for chronic anal fissure. The optimal and standardized sphincterotomy has the utmost importance in preventing postoperative incontinence and recurrence, which are consequences of either extreme or insufficient sphincterotomy. Therefore, the lateral internal sphincterotomy technique has been evolved within years with the initial proposition of controlled-sphincterotomy and improvement of this technique with the addition of sphincterotomy up to the dentate line. This chapter focuses on the chronic anal fissure in the era of spasm-controlled lateral internal sphincterotomy.

show abstract

Anal Fissure – an extensive update

Cited by 13 publications

References 0 publications

Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial

Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial

Lateral Internal Anal Sphincterotomy of Chronic Anal Fissure: An Experience of 165 Cases

Sphincterotomy is the Gold-Standard Treatment of Chronic Anal Fissure: But How Should it be Done?

Contact Info

Product

Resources

About