An anal fissure is a tear in the skin lining the inside of the anus which can be caused by constipation. If a fissure does not heal on its own, surgical treatment can help.
Once the skin lining the inside of the anus has a tear, the muscle underneath it can go into spasm. This tightens the anus further making it more painful and difficult to open your bowels, particularly if you remain constipated. You may also find that you pass blood and have a sore anus for a few hours after each bowel movement.
Some fissures heal on their own and this healing process can be helped by eating plenty of fruit and vegetables, and drinking lots of fluid to avoid constipation. Surgery may be needed if they don't heal on their own.
According to clinical sources, as well as constipation, other triggers for an anal fissure can include inflammatory bowel disease like Crohn's disease and ulcerative colitis, persistent diarrhoea, pregnancy and childbirth, having tight sphincter muscles and - occasionally - a sexually transmitted infection such as herpes or syphilis.
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You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
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Anal sphincterotomy surgery is done under general anaesthesia, which means you'll be asleep during the procedure and will feel no pain.
During the procedure, your surgeon will make a cut in the ring of muscle (the sphincter) that controls the opening and closing of the anus. This will relax the sphincter and help prevent spasm. This means you will need to strain less when you go to the toilet, allowing the fissure to heal.
Your surgeon will make the cut in such a way that it should not allow the anus to open too easily and affect your continence (the ability to control gas and bowel movements).
Afterwards, a pad dressing will be put into your anus to help stop bleeding.
The operation to treat an anal fissure is usually performed as a day-case, but sometimes you may need to stay overnight in hospital.
After the procedure, you will be taken from the operating theatre to a recovery room, where you will come round from the anaesthesia under close supervision.
After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you're ready to go home.
After an operation to repair an anal fissure, you are likely to feel sore for a number of days. If you need them, continue taking painkillers as advised by the hospital.
We will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've left hospital, up to 14 days. This may be at an additional cost to some patients.
The wound can take up to four weeks to heal, after which time you should be able to resume normal activities.
Once you're ready to be discharged from hospital, you'll need to arrange a taxi, friend or family member to take you home as you won't be able to drive.
Even after you've left hospital, we're still looking after you every step of the way. After surgery for an anal fissure, we will provide you with advice and follow-up support.
At your follow-up appointment your surgeon will decide whether you need to continue with daily dressings.
On rare occasions, complications following surgery for an anal fissure can occur. The chance of complications depends on the exact type of operation you are having and other factors such as your general health. We will talk to you about the possible risks and complications of having this procedure and how they apply to you.
If you have any questions or concerns about your recovery, we're ready to help.
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The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.