Anal fissure (or fissure)
Anal fissure is a crack linear anodermis, which is a specialized skin lining the anal canal. Rupture occurs suddenly, usually during defecation. Characteristic picture of the disease is severe pain during bowel movements, which may persist for several hours after defecation. In addition to the pain the patient may become worried due to vivid red blood on the stool or on toilet paper. It happens that the bleeding is quite generous. Symptoms are most severe in the early days of the disease, the time is mitigated.
The concept of anal fissure treatment is based on the assumption that the reason for the lack of progress in healing is a disorder in the blood supply to damaged tissues caused by excessive contraction of the anal sphincter muscle which generates excessive pressure in light of the anal canal. There are several ways to relax this muscle, the most effective are:
• paralysis of the anal sphincter by administering botulinum toxin directly into the tissue of internal anal sphincter called by some pharmacological sphincterotomy.
• sphincterotomy with CO2 laser – Operative technique which involves cutting part of the anal sphincter muscle fibers visible at the bottom of the unhealed cracks.