By Dr. Pravin Gore, Proctology
Anal fissures are caused by an injury to the anal canal tear, resulting in pain, bleeding and difficulty in the bowel movement. The lining needs to be healed and the pain needs to be managed.
There are many Allopathic, Homeopathic and Ayurvedic treatments available for Anal Fissure. In addition to those, the Botox treatment is also a recommended option for Anal fissure. This is something that not many people are aware of.
Botulinum Type A injections injected into the sphincter relieve pain and quicken the healing. The only side effect is a temporary loss of control over the muscles that control bowel movement and farting. But everything becomes normal within a few hours.
Acute and Chronic Anal Fissures
Acute anal fissures last less than 6 weeks and usually heal with self-care. Chronic fissures, on the other hand, might come with external lumps and tears called sentinel piles, or extra tissues called hypertrophied papilla, and need medical or surgical assistance.
Self-Care for Acute Anal Fissures
Here is how acute anal fissures can heal with a proper lifestyle:
● Ample hydration.
● Avoiding caffeine and alcohol.
● A fiber-rich diet (30 grams of daily fiber intake).
● OTC laxatives to assist with constipation.
● Not ignoring chronic diarrhea or constipation.
● Cleaning the area gently and avoiding irritants like fragranced soaps.
Other Treatment Options
Self-care is not always enough. If the symptoms persevere beyond 6 weeks, the patient must seek professional help. The common medical routes taken in the cure for anal fissures are:
● Nitrate ointment: This raises blood flow and heals the fissures quicker. There may be side effects like low blood pressure, dizziness, headaches and complicated side effects if taken within 24 hours of ED medication.
● Calcium channel blockers: This blood pressure lowering medication can also cause headaches, especially if orally taken.
● Surgery: When medication is not enough, lateral internal sphincterotomy is a minor surgery that solves the problem. There is a temporary loss of sphincter control. Complete healing usually happens within 8 weeks.
The Botulinum toxin is the least painful way to go with anal fissures. There are no side effects like nausea or headaches involved. There is no pain or recovery time involved as in the case of surgery.
Botox is directly injected into the internal sphincter muscle. This assists sphincter relaxation and eventual healing of the injured muscle. Up to 80% people suffering from chronic anal fissures heal with Botulinum toxin injections, and that too in a short span of time.
The procedure is simple and almost painless. It does not require the patient to be admitted to a hospital unless there are other complications apart from anal fissures. The procedure can be performed even in the OPD office setting in some cases. Symptoms recur in about 40% patients. But subsequent re-injection treatment is always more effective than the previous one. In the rare case the injection does not work, the patient needs to resort to traditional sphincterotomy surgery.