Anal fissures occur due to constipation, diarrhea or too much pressure on the anal canal. The lining of the anal canal is similar to the gums and mouth which have very thin layer of skin and are sensitive to tension and pressure.
Given the opportunity, they heal quickly but there are times when they become chronic and will not heal for a long time. The internal sphincter causes an involuntary spasm and prevents blood supply to the fissure, disrupting the healing process. Due to this, brittle scar tissues form over the fissure. These brittle scar tissues will tear every time you do a bowel movement, causing pain and discomfort.
People who have undergone Ileoanal anastomosis or J Pouch surgery due to Ulcerative Colitis, Crohn’s Disease and other large intestine conditions and who also suffered from anal fissure reported relief from their fissure and apparently, their fissures went away after the surgery.
J Pouch is an internal reservoir that is surgically constructed near the area where the rectum would have normally been. The loops of small intestine, known as ileum, are folded back and are stapled or stitched together then, the internal walls are removed to form the reservoir. This reservoir will then be attached into the perinium where the rectum would have been by stapling or stitching. This procedure retains the functionality of the anus, allowing stool passage under the patient’s voluntary control.
On the other hand, chronic anal fissures cause a lot of discomfort and pain. These fissures do not seem to heal and others even become bigger than they were previously. For such kind of fissures, laser surgery can help. Although this procedure is much more expensive compared to other surgical treatments, it has high success rate and it can be done as an out-patient procedure.
This procedure involves the use of local anesthetic. This procedure is done by incising the internal sphincter using the laser. In some cases, a speculum is administered into the anus and the fissure is vaporized using the laser. In other laser procedures, a portion of the anal canal muscle is cut to prevent spasm on the sphincter. Although the fissure remains, the excess scar tissues are also removed to facilitate the growth of healthy tissue and boost healing of the fissure. There are cases wherein the fissures are cut bigger by surgeons to optimize healing.
People with chronic anal fissure who suffered for a long time reported great relief after undergoing this treatment. Due to its high efficiency rates, most surgeons recommend this procedure for chronic, painful fissures that do not seem to heal. If anything else fails, this procedure can be a great alternative.
Although there are natural and non-surgical treatments for fissures, you can always opt for these non-invasive surgical procedures if nothing else works. It is still best to try the non-surgical methods before jumping into surgery. If, your pain does not go away and it affects you and your lifestyle, then you can always discuss the pros and cons of these procedures with your doctor.
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