Q. What is the treatment for recurrent anal fissure?

Questions 

Hi doctor,

I am a 22 year old female. I have been having constipation since a year. I am having anal fissures. The doctor says that the fissure has healed, but I still have a burning sensation and mild itching in and around the anus. There is increased burning after bowel movement. I have had two episodes of fissure in this year, but they were not as severe as this. I am taking Cetirizine, Anobliss cream and Siloderm cream. Earlier, as I had perianal itching along with fissure and worms I took one full course of Mebendazole. My stool microbiology suggests there is no worm infestation.

Answered

Hello,

Welcome to dr.sitehome.info.

• Episode of pain and itching suggest healing phase of the fissure. This time pain is because of slight narrowing of the anal canal at the fissure site due to the replacement of normal tissue with fibrous tissue.

• You should continue these medications and if there is no swelling in the anal region, then consider for surgery as you have repeated episodes of pain due to a fissure.

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The Probable causes:

Constipation.

Investigations to be done:

Digital rectal examination and proctoscopy.

Probable diagnosis:

Anal fissure.

Treatment plan:

Continue the same treatment. Try to reduce the use of tablet Cetirizine and consider surgery for fissure.

Preventive measures:

Treatment for constipation.

Regarding follow up:

For further information consult a surgical gastroenterologist online.—> https://www.dr.sitehome.info/ask-a-doctor-online/surgical-gastroenterologist

 

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