]WHAT IS IT
It is a wound, a wound of the anal rhyme, which can become chronic from acute in 25% of cases if not treated promptly. Presents the same frequency in both sexes, in 70-80% of cases occur posteriorly, where it takes place the intersection of the sphincter fibers and therefore a lower resistance area. In 10% of women it is always presented before for the presence of a lower resistance area, since this is the prostate in men. Rare is the lateral fissure.
ONSET OF CAUSES
The main cause is certainly the issue of hard stools, which determine the anal del’epitelio tear, follow the diarrhea, the local inflammation. Stress and somatization can, through the anal spasm, determine the maintenance of the fissure. More rare and secondary to trauma and surgery (fistulectomie, haemorrhoidectomy).
EVENT
Pain is the main symptom due to the disappearance of the epithelium of the anal canal and highlighting the muscular sphincter transverse fibers, absent if the patient does not defecates.
The peculiarity of the pain from anal fissure is manifested in three stages. At first, it currently passing stools pain is sharp, stabbing, then it follows a period free from the pain and after 5-10 minutes appears a sharp pain, burning, unbearable that will last for hours only then disappearing spontaneously.
Often at the end of defecation it is a modest bleeding, itching and burning.
The sphincter spasm is a characteristic feature of anal fissure that often highlighting physical examination makes it difficult. characteristic features of chronic fissures, growth expression of tissue repair incomplete, are Marisca this sentry outside the fissure and hypertrophic papilla inside the anus.
DIFFERENTIAL DIAGNOSIS
Some diseases can apparently manifest itself as an injury-tear like tissue ragadiforme as: the anus cancer, syphilitic chancre, ulceration anal Crohn’s disease.
It will therefore be useful histological confirmation after the intervention.
TREATMENT
We must distinguish the two forms the acute and the chronic.
In the first case the fissure just arisen is treated, with success, with the medical therapy. This provides immediate regularization of the diet with the addition of an appropriate amount of fiber and water (two liters per day), food supplements, no laxative. Essential for healing is introducing several times a day of a dilator, for about 5-7 minutes previously immersed in a warm hot-water and warm-hearted bidet needed to reduce the pressure of anal sphincter. Initially are useful analgesics for pain relief.
The chronic form, which persists for a long time, is exclusively treated with surgical therapy being that a medical absolute loss of time.[/vc_column_text][vc_row_inner][vc_column_inner el_class=”” width=”1/3″][ultimate_modal icon_type=”none” modal_title=”Get informed consent” modal_contain=”ult-html” modal_on=”button” onload_delay=”2″ btn_size=”lg” btn_bg_color=”#325b7b” btn_txt_color=”#ffffff” modal_on_align=”center” btn_text=”Get informed consent” txt_color=”#f60f60″ modal_size=”medium” modal_style=”overlay-cornerbottomleft” overlay_bg_color=”#333333″ header_text_color=”#333333″ modal_border_width=”2″ modal_border_color=”#333333″ modal_border_radius=”0″]
Informed consent for anal fissure
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