Diagnosis and Treatment of Anal Fissures in 2021

Ling, Yang; Kwaan, Mary R.; Lin, Anne

doi:10.1001/jama.2020.16705

Cited by 9 publications

(5 citation statements)

References 11 publications

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“…Anal fissures affect a large and diverse population of all ages. A conservative approach should be explored and should be considered for all cases before prioritizing the gold-standard surgical treatment [4]. Currently, only a few studies have looked into the effectiveness of sitz baths in treating anal fissures.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Sitz Baths as Compared to Lateral Internal Sphincterotomy in Patients with Anal Fissures: A Systematic Review

Alnasser¹,

Akram²,

Kar³

et al. 2022

Cureus

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An anal fissure is a common condition that affects patients of all ages. Its clinical presentation is a sharp pain on defecation with or without blood. It is treated by conservative or surgical means. This study aims to assess the efficacy of a sitz bath as compared to lateral internal sphincterotomy in the treatment of anal fissures. The search strategy used keywords related to the topic of study. Three databases were used: PubMed, Google Scholar, and Science Direct. A total of 551 articles were screened. A quality assessment check was done on the articles leaving 11 articles. Four aspects of sitz bath outcomes were evaluated in the articles. In terms of analgesia, articles showed conflicting evidence. However, the overall evidence supports the use of sitz baths for their analgesic properties. In terms of healing, most articles had similar recovery rates of around 80%. Much of the research supported the use of sitz baths as the primary treatment to heal acute fissures. When compared to lateral internal sphincterotomy, the recovery rates of lateral internal sphincterotomy are superior to those of conservative treatment, including sitz baths. However, studies showed incontinence as a side effect of lateral internal sphincterotomy, and no studies reported side effects from the sitz baths. To conclude, the results of the articles support the use of sitz baths to treat anal fissures. Sitz baths have been found to have analgesic properties, as well as a good healing time. But, compared to lateral internal sphincterotomy, there is a significant difference in the healing rate at the end stage of treatment, lateral internal sphincterotomy is found to be superior. With regards to the side effects, none have been reported from using a sitz bath.

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Section: Introductionmentioning

confidence: 99%

The Efficacy of Sitz Baths as Compared to Lateral Internal Sphincterotomy in Patients with Anal Fissures: A Systematic Review

Alnasser¹,

Akram²,

Kar³

et al. 2022

Cureus

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“…Anal fissures are commonly found in middle-aged adults and in children. 9 They are primarily diagnosed by clinicians, with symptoms including pain during or after passage of stool, rectal bleeding, and linear tear (with or without a sentinel tag). 10 Most fissures are at the midline.…”

Section: Methodsmentioning

confidence: 99%

“…11 Differential diagnosis of severe anal pain includes fissure, thrombosed hemorrhoids, or perirectal abscess 9. Rectal bleeding is not necessarily diagnostic of malignancy but requires assessment and consideration of other risks factors 12.…”

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confidence: 99%

Topical treatments for anal fissure

2023

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“…A gently performed digital rectal examination will confirm the diagnosis with exquisite tenderness, and rarely anoscopy is needed (Figure 3B). The most common cause is constipation, passage of hard bulky stool, and, rarely, chronic diarrhea (43).…”

Section: Anal Fissuresmentioning

confidence: 99%