Anal Fissures

Anal fissures are characterized by the presence of cracks in the lining of the anus at the anal opening. Passage of very hard stools or recurrent passage of watery stools is the most common cause of anal fissures. The underlying muscles at the anal opening are exposed due to an anal fissure. It is very painful condition as the muscles get irritated from exposure to air and stool. The symptoms are bleeding, intense burning pain and occurrence of spasm after passage of stool.

Majority of the anal fissures heal by themselves and no treatment is required except for maintaining good diaper hygiene in infants. The various home care methods that can be used to heal anal fissures include :

• Increasing intake of high fiber foods and foods that increase the bulk of the stool
• Taking sitz baths
• Cleaning gently after passage of stool
• Taking pain medicine to reduce pain
• Applying muscle relaxants to the skin to prevent spasm
• Applying anesthetic cream if there is interference with normal passage of stool due to pain
• Applying petroleum jelly to the affected area
• Taking stool softeners
• If the home care methods described above are not successful in healing the fissure, then the following may be recommended:
• Injecting Botox into the anal muscle (anal sphincter)
• Performing minor surgery on the anal muscle to relax it

Usually anal fissures heal quickly without complications. However, there are chances of recurrence in individuals who have once developed anal fissure.

It is a medical procedure that involves screening of whole of the colon. The procedure is performed for early screening of colorectal cancer. It is also performed in order to evaluate the etiology behind unexplained weight loss, changes in bowel habits, pain, blood in stool or rectal bleeding, etc.

Before starting the procedure, your doctor shall explain you all the steps that would take place during colonoscopy. You shall be given a liquid diet which you ought to follow for 1-3 days before the procedure (as the doctor guides). You may be asked to take a laxative a night before the procedure, so that your colon gets cleansed prior to the insertion of the colonoscope. You may also be given an enema instead of laxative.

For the procedure, you will be asked to lie on your left side on the examination table. You will then be given analgesics and moderate sedatives which shall aid you in relaxing and bearing the pain during the procedure. Once you are sedated and stable, a long and flexible tube known as ‘colonoscope’, shall be inserted through your anus into your rectum, slowly upwards and towards your colon. Some patients complain of discomfort during this part of screening. The scope is flexible enough to curve according to the path of colon. It also blows air into it so that a better view of the inside can be obtained. The colonoscope transmits an image onto the screen, which your doctor views so as to discover any abnormal outgrowths, masses, inflammation and ulcers.

This whole procedure lasts for about 30 to 60 minutes. While recovering, cramping and bloating may be faced for the very first hour after the procedure. The effects of sedatives may take time to wear off completely. Discharge is instructed on the basis of the condition of the patient. Complete recovery takes at least one day to occur.

Another procedure which allows a physician to examine the large intestine is known as sigmoidoscopy. A flexible sigmoidoscope is inserted via rectum and is slid along upwards till the sigmoid arrives.

You shall be required to lie on your left side on the examination table. You shall be given analgesics and sedatives. Your vitals will be monitored and maintained. After this, the doctor will introduce a short and flexible tube called sigmoidoscope through your rectum and slide it upwards until it reaches the sigmoid. This flexible instrument transmits images of the part of the intestine which shall be monitored by your doctor for the presence of any tumor, polyps, inflammation, etc. Samples of abnormal tissue (if any) can also be obtained for biopsy using a sigmoidoscope. This whole procedure takes about 10 to 20 minutes in total.

You may be required that you remain on liquid diet for at least 12 to 24 hours before the procedure. You may be prescribed laxatives a night before, or may be given enema to cleanse and clear out your bowel completely.