An anal fissure is a tear in the anal skin usually caused by a high anal muscle tonus and or hard stools and is causing sharp pain, especially during and after defecation.

Causes

Straining to defecate (especially in case of hard stools), severe & chronic constipation, severe & chronic diarrhea, Crohn’s disease or ulcerative colitis, anal stretching (anal sex, dildo use, anal probing, etc.), tight anal sphincter muscles.

Symptoms

Pain during and even hours after defecation, a visible tear in the anus, blood on stool (or in toilet bowl) or on toilet paper (70%), constipation, burning and possibly painful itch.

Diagnostics

No imaging is needed, just a anal exam possible with proctoscopy will do.

Treatment

It is usually treated by anal creams/ointments (containing: anti-inflammatory, local anesthetic, nitroglycerine or nifedipine) , which have to be brought into the anus multiple times per day for one month to relax the anus, painkillers, warm sitz baths, and by dealing with the constipation (more drinking, more fibres, laxatives).

If this treatment does not help or when the fissure has high elevated walls surgical treatment by excising these walls combined with botox injections can be needed.

Risks of the surgery

Recurrence, pain, bleeding, scarring

Why chose Professor Guido Mannaerts MD PhD

Is a Netherlands double board certified gastrointestinal and oncological surgeon with who is dedicated to minimal scar incision surgical approaches.
As being an Adjunct Professor at the UAE University and a broad research background Professor Guido is aiming for state of the art surgical care using the latest techniques.
His pleasant, honest, patient-centred care and being committed to achieve the best results for you makes you feel being treated like a family expert.