Fissure & Fistula Treatment
Fissures and fistulas are two common yet painful conditions affecting the anal region. These conditions can significantly impact a person’s quality of life, making it essential to understand their causes, types, treatment options, and the potential for surgical intervention. This comprehensive guide will explain the differences between anal fissures and fistulas, their causes, types, available treatments, and surgical procedures.
What is a Fissure?
Anal Fissure is a small tear or cut in the lining of the anus, typically caused by trauma to the anal canal. This tear results in severe pain during and after bowel movements, often accompanied by bleeding.
Causes of Fissure:
- Constipation: Hard stools can tear the anal tissue.
- Straining: Excessive straining during bowel movements increases pressure on the anal canal.
- Chronic Diarrhea: Frequent bowel movements irritate the anal lining.
- Childbirth: Vaginal delivery may cause a tear in the anus.
- Inflammatory Bowel Diseases (IBD): Conditions like Crohn’s disease lead to anal inflammation, increasing fissure risk.
What is a Fistula?
Anal Fistula is an abnormal tunnel-like connection between the skin near the anus and the anal canal. It develops due to an infected anal gland, which forms an abscess that fails to heal completely.
Causes of Fistula:
- Anal Abscess: Infection in an anal gland leading to abscess formation.
- Crohn’s Disease: Chronic inflammation in the intestines may cause fistulas.
- Tuberculosis: Rare, but can lead to fistula formation.
- Trauma or Surgery: Previous surgeries or injuries in the anal region may increase the risk.
- Radiation Therapy: This therapy for cancer patients may lead to fistula formation.
Types of Fissures & Fistulas
Types of Fissures
- Acute Anal Fissure: Recent tears that may heal on their own with conservative treatment.
- Chronic Anal Fissure: Long-standing tears that often require medical or surgical intervention.
Types of Fistulas
- Intersphincteric Fistula: The fistula starts between the internal and external anal sphincters.
- Transsphincteric Fistula: Passes through the external sphincter and opens onto the skin.
- Suprasphincteric Fistula: Starts above the sphincter muscles.
- Extrasphincteric Fistula: Begins from the rectum and extends to the skin, passing outside the sphincter.
- Submucosal Fistula: Located close to the lining of the anal canal.
Treatment for Fissure and Fistula
Fissure Treatment
- Conservative Treatments:
- Dietary Changes: High-fiber diet to soften stools.
- Stool Softeners: Reduces strain during bowel movements.
- Topical Ointments: Nitroglycerin, calcium channel blockers, or steroid creams to relax the anal muscles and promote healing.
- Sitz Baths: Warm baths to soothe pain and promote blood flow.
- Botox Injections: Temporarily paralyzes the anal sphincter muscle to allow healing.
- Surgical Treatments:
- Lateral Internal Sphincterotomy (LIS): A small incision is made in the anal sphincter muscle to reduce pressure, allowing the fissure to heal.
- Fissurectomy: The removal of the fissure along with any surrounding scar tissue.
Fistula Treatment
- Conservative Treatments:
- Antibiotics: To treat infections and reduce symptoms, although this is often not a permanent solution.
- Fibrin Glue: Injected into the fistula to seal the opening, though this treatment may not be very effective for complex cases.
- Surgical Treatments:
- Fistulotomy: The most common procedure where the fistula tract is opened up and allowed to heal from the inside out.
- Seton Placement: A medical thread is placed through the fistula to slowly help it drain and heal.
- Advancement Flap Procedure: A flap of healthy tissue is used to cover the internal opening of the fistula.
- LIFT (Ligation of Intersphincteric Fistula Tract): The fistula tract is tied off to prevent further infection while allowing the tissue to heal.
Surgical Procedures for Fissure and Fistula
- Lateral Internal Sphincterotomy (For Fissures) : anal sphincter muscle to relieve pressure and pain, allowing the fissure to heal. This procedure has a high success rate, but in rare cases, it can lead to minor incontinence.
- Fistulotomy (For Fistulas) : During this procedure, the surgeon opens the fistula tract, converting it into a flat wound, which is left to heal. This is the gold standard for treating fistulas but may not be suitable for fistulas that pass through a large portion of the sphincter muscle, as it may risk incontinence.
- Seton Technique (For Complex Fistulas) : Seton placement is used for more complex fistulas that involve a significant portion of the sphincter muscle. A seton (a surgical thread) is placed inside the fistula to allow it to drain and gradually heal over time. It helps avoid damage to the sphincter.
- Advancement Flap Procedure : In cases where the fistula is complex and at risk of incontinence, an advancement flap procedure may be used. The surgeon removes the fistula’s internal opening and covers the area with a flap of healthy tissue to allow healing. This procedure preserves the sphincter muscle.
- LIFT (Ligation of Intersphincteric Fistula Tract) : LIFT is a minimally invasive technique designed to treat complex fistulas while protecting the sphincter muscle. The surgeon makes a small incision and ties off the fistula tract, reducing the risk of incontinence and promoting healing.
Meet the Best Doctor for Fissure and Fistula Treatment in Gwalior
Are you suffering from painful anal fissures or a recurring fistula? Finding the right doctor for these conditions can make all the difference in your treatment and recovery. If you’re in Gwalior, look no further than Dr. Shubham Gupta, a renowned specialist in treating fissures, fistulas, and other anorectal disorders.
Why Choose Dr. Shubham Gupta?
Dr. Shubham Gupta is recognized for his expertise and compassionate care in anorectal surgery. He is highly trained in minimally invasive techniques that offer quicker recovery and reduced discomfort for his patients. Whether you’re dealing with a simple fissure or a more complex fistula, Dr. Gupta’s advanced treatment methods, including laser surgery and the latest medical interventions, ensure effective and lasting relief.
- Expertise in Minimally Invasive Surgery: Dr. Gupta specializes in laser treatments and advanced surgical techniques, ensuring minimal pain and faster healing.
- Comprehensive Care: From initial diagnosis to post-surgical care, Dr. Gupta provides a personalized treatment plan tailored to your condition.
- High Success Rate: With extensive experience in fissure and fistula treatments, Dr. Gupta boasts a high success rate, with many patients experiencing quick recovery and long-term relief.
- Patient-Centered Approach: Dr. Gupta prioritizes patient comfort and safety, ensuring that each step of your treatment is as smooth and stress-free as possible.
