Why Surgery Isn’t Always the Answer for Anal Fissures: Conservative Treatments That Work

Anal fissures are tiny tears in the lining of the anus that can cause intense pain, bleeding, and discomfort during bowel movements. They’re a common problem that affects people of all ages, but they can be particularly uncomfortable due to their painful symptoms. When experiencing such pain, many people fear they might need surgery to get relief. However, surgery isn’t always necessary for treating anal fissures. Conservative treatments are often highly effective.

Dr. Samrat Jankar is a leading proctologist and colorectal surgeon in Pune at Kaizen Gastro Care. With 15+ years of experience and expertise in treating anal fissures, hemorrhoids, and other anorectal disorders, he provides compassionate care with a focus on minimally invasive treatments. Let’s delve into why surgery isn’t always the answer and the conservative treatments that work effectively for anal fissures.

Understanding Anal Fissures:

An anal fissure is a small tear in the thin, moist tissue lining the anus. It usually happens due to trauma from passing hard or large stools, chronic diarrhea, or even constipation. Anal fissures can also be linked to inflammatory bowel diseases like Crohn’s disease. Common signs include:

Sharp pain during and after bowel movements
Bright red blood on the stool or toilet paper
Itching or irritation around the anus
A visible crack in the skin around the anus

Most acute anal fissures heal on their own with proper care, whereas chronic fissures may require medical intervention.

Why Surgery Isn't Always the First Choice:

Surgery for anal fissures, such as lateral internal sphincterotomy, is effective but isn’t the first line of treatment due to potential risks, including:

Incontinence: Risk of gas or stool leakage due to sphincter muscle weakening.
Complications: Like infection or delayed healing.
Recovery Time: Post-surgery discomfort and time off from regular activities.

Given these risks, conservative treatments are suggested initially. Dr. Samrat Jankar emphasizes that non-surgical options can heal the fissure and relieve signs effectively without the need for invasive procedures.

Conservative Treatments That Work:

Dietary Modifications: One of the most effective conventional treatments for anal fissures is improving your diet. A high-fiber diet helps soften the stool, making bowel movements less painful. Include:

Whole grains, fruits, and vegetables for soluble and insoluble fiber.
Plenty of water (8-10 glasses daily) to prevent dehydration and constipation.

If dietary changes aren’t enough, fiber supplements like psyllium husk or methylcellulose can also be beneficial.

Sitz Baths: Soaking the anal area in warm water for 15-20 minutes, 2-3 times a day, can:

Relieve pain and discomfort.
Promote blood flow for faster healing.
Relax the anal sphincter, reducing spasms.

Adding Epsom salt can enhance the soothing effect.

Topical Medications: Several ointments can help in healing anal fissures, including:

Nitroglycerin ointment: Relaxes the anal sphincter, relieving pain and promoting healing.
Calcium channel blockers: Work similarly to nitroglycerin but with fewer side effects like headaches.
Topical anesthetics: Provide temporary pain relief.

Consult Dr. Samrat Jankar before using these medications to ensure the right dosage and application method.

Stool Softeners and Laxatives: Temporary use of stool softeners or osmotic laxatives like polyethylene glycol can help maintain soft stools, controlling the recurrence of fissures. However, these should not be used long-term without medical supervision.
Pain Relievers: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help control discomfort. However, avoid opioid painkillers as they can cause constipation, worsening the fissure.
Botox Injections: In cases where topical treatments fail, Botox injections can be considered. Botox relaxes the anal sphincter muscle, promoting healing. It’s a minimally invasive procedure that provides ease without the risks associated with surgery.

When is Surgery Necessary?

While conservative treatments are effective for most patients, surgery might be required if:

The fissure is chronic and hasn’t healed after 6-8 weeks of conservative treatment.
Severe pain persists, affecting the quality of life.
There’s an underlying condition like Crohn’s disease contributing to the fissure.

In such cases, Lateral Internal Sphincterotomy is the most common surgical procedure performed. It involves making a small cut in the anal sphincter muscle to relieve spasm and pain, allowing the fissure to heal. The best fissure specialist in Pune, Dr. Samrat Jankar specializes in minimally invasive techniques to ensure a quicker recovery and minimal discomfort.

Conclusion:

Surgery isn’t always the answer for anal fissures. In fact, most fissures heal with conservative treatments like dietary changes, sitz baths, and topical medications. If you’re experiencing symptoms of an anal fissure, don’t suffer in silence. Visit Kaizen Gastro Care for an expert evaluation and a personalized treatment approach.

Book your appointment with Dr. Samrat Jankar today!