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Cracks in the anus – This is the most common complaint that patients make to a proctologist. Not a single person is immune from their appearance, but most often they form in older people. A crack in the anus can appear both by itself and be the result of other diseases of the digestive system.
The essence of pathology
A fissure in the anus is a violation in the normal structure of the rectum, which is the final section of the large intestine. Such a crack, in fact, is a common rupture of the mucous membranes.
Most often, the size of the defect is small. However, this does not prevent him from significantly reducing the quality of life of the patient. If a person suffers from hemorrhoids for a long time, then cracks can even extend to the side walls of the anus.
Like any other disease, fissures can be acute or chronic. Up to 25% of all patients come to the proctologist with acute fissures.
Acute form
The main characteristics of acute anal fissure:
Severe pain during bowel movements, which subsides on its own after 15-20 minutes. The pain is throbbing.
Pain occurs with every contraction of the sphincter.
Intermittent bleeding. In this case, the blood will have a bright red light. It can stand out drop by drop, or flow in a jet.
On examination, the doctor visualizes the site of inflammation on the intestinal wall. When touched, the patient complains of acute pain.
Chronic form
Characteristics of chronic anal fissure:
Weak pains that increase after the act of defecation. After a few minutes, they are completely gone. Also, painful sensations will disturb if the stool is disturbed with a diet error and during any straining.
Blood that is visible in the stool.
Thickening of the intestinal wall.
Normal sphincter tissue is replaced by scar tissue.
The symptoms of the disorder keep recurring.
Predisposing factors
Risk factors for the formation of a crack in the anus:
Constipation and diarrhea, that is, any chronic violation of the stool.
Diseases of the rectum and large intestine: colitis, hemorrhoids, proctitis, IBS, etc.
Crohn’s disease.
Errors in the diet. The danger is the consumption of salty and spicy foods, as well as the intake of alcoholic beverages.
Anal sex.
Video: Live Healthy “Anus fissure. What causes constipation?
Surgery
Indications for surgery for patients with anal fissure:
Lack of effect from taking medications (subject to therapy for at least 6-8 weeks).
Complaints of the patient on the expressed discomfort.
Complications of anal fissure.
Combination of anal fissure and hemorrhoids.
Fecal incontinence.
Surgical care for anal fissures can be of the following types:
Divulsion of the anus. This is a kind of “middle” between surgery and conservative therapy. The patient is given anesthesia, after which the sphincter is expanded. This procedure is not prescribed for older people.
Cryodestruction. You can try to fix an anal fissure with liquid nitrogen, but this treatment does not always solve the problem.
Sphincterotomy. During the operation, the crack is excised. If the patient has a spasm of the sphincter in parallel, then it is subject to dissection. Recovery takes up to 6 days. After this time, dressings with Levomekol are required.
The sooner treatment is started, the faster it will be possible to cope with an anal fissure. If a person does not delay going to the doctor, then it will be possible to get rid of the problem with the help of conservative therapy.
Ozone therapy of the intestine – will it help?
Ozone therapy used to be used only in cosmetology, but doctors borrowed this method to treat the intestines. It involves taking 8 ml of blood from a patient, after which it is separated into plasma and erythrocyte mass in a centrifuge. The plasma is additionally enriched with biologically active substances and platelets, after which it is injected into the patient in the area under the anal fissure. This allows tissues to recover faster.
Plasma can be enriched with ozone, which will increase the therapeutic effect and further stimulate the patient’s immune system. Ozone therapy for anal fissures is actively used in various countries. In recent years, this method has begun to gain popularity in Russia.
Zagryadsky A. E (Professor, Doctor of Medical Sciences, member of the Russian Academy of Medical Sciences, Head of the Department of Proctology of the MC ON CLINIC): “There are clear protocols for the treatment of anal fissures. Ozone therapy is not included in these protocols. In order for the patient to recover, it will be necessary to normalize the stool, relieve spasm from the sphincter, stimulate tissue healing, and increase blood circulation in the capillaries. To achieve the latter goal, phlebotonics are prescribed: Phlebodia or Detralex.
Lagodich L. G (surgeon, traumatologist, proctologist): “It will not be possible to cope with an anal fissure with one single method. We need an integrated approach.”
Laser and other minimally invasive surgeries
Minimally invasive techniques are being used to treat anal fissures more and more often. They are not associated with the risk of complications and allow you to quickly get rid of the existing problem.
Procedures that can be used to treat anal fissure:
Laser treatment.
Electrocoagulation of cracks.
Treatment of cracks with ultrasound.
It is laser treatment that is used more often than others.
How to cure an anal fissure after childbirth?
Anal fissures often occur in women after childbirth. During attempts, the anus experiences enormous loads, and the perineum is stretched. As a rule, obstetricians do not treat cracks, but after 2 days a woman experiences pain when trying to empty her intestines. To soften the feces, it is required to take drugs that do not penetrate into milk, or do not enter the systemic circulation. You can not ignore the problem, you need to contact the doctor with it.
Treatment is reduced to the use of suppositories with sea buckthorn, Duphalac, Methyluracil. Sometimes doctors prescribe posterizan suppositories, and for treating the skin around the anus, Emla and Cathejel gel.
It is important to start treatment immediately after delivery. If the defect does not pass for more than 3 months, then the edges of the crack become keratinized, and metabolic processes in the affected tissues slow down. In such a situation, the help of a surgeon may be required.
Fissure of the anus in a child
Anal fissures are common in children. The child will suffer from acute manifestations of the disease, the process is rarely chronic. Parents should pay attention to the refusal of the baby to go to the toilet, or to his long pastime on the potty. At the same time, he can cry and act up. If adults find an anal fissure in a child, you need to contact a doctor.
A child suffering from constipation is prescribed Duphalac (Lactulose). It will be necessary to follow a diet, offer the baby a varied and plentiful drink. Older children should eat soups. If constipation is of a neurological nature, then you need to consult a neurologist. The doctor may prescribe sedatives to the patient, which are suitable for the treatment of children.
In some cases, it is required to get rid of worms, treat dysbacteriosis.
If the baby is haunted by diarrhea, then he is prescribed Stop-diar and Ersifuril. Macrophages can also be used. Eubiotics are taken within a month after the completion of the main therapy.
To facilitate the discharge of feces, children under one year of age are prescribed suppositories with sea buckthorn oil. They are divided into 2 parts and used 2 times a day. Children older than a year are inserted into a whole candle in the morning and evening. Baths with disinfecting herbs, for example, chamomile or calendula, contribute to the speedy healing of cracks.
To anesthetize the affected area, Oflokain is prescribed. It contains an analgesic and an antibiotic. Levomekol is prescribed for up to 7 days, this ointment allows you to accelerate healing. The dose must be strictly observed, as the drug can cause anemia and lead to a decrease in the level of leukocytes in the blood.
Within 5 days, you can use suppositories or Aurobin ointment. Children are inserted by? candles, or apply 0,5 cm of ointment. In addition, in childhood, drugs such as D-panthenol, Methyluracil, Bepanten can be used.
Prevention
To prevent the formation of anal fissures, you need to follow simple recommendations:
Empty the bowels in time, get rid of diarrhea or constipation.
Go in for sports, swim, walk as much as possible.
Drink at least 2 liters of water per day.
Follow the rules of personal hygiene.
Treat all diseases of the gastrointestinal tract in time.
Do not try to cope with diseases on your own.