This is a procedure to treat chronic anal fissures. An anal fissure is a painful tear in the lining of the anus. The anus is the opening through which stool passes from the body. Tears generally occur just inside the opening.
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Muscle spasms in the rectum can prevent fissures from healing. A sphincterotomy relieves these muscle spasms. Anal fissures often heal by taking certain steps, such as:
When these do not work, a sphincterotomy may be done. This procedure allows the fissure to heal and decreases pain and spasms. Pain will begin to go away within a few days.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Before surgery, your doctor may do the following determine the extent of your fissure:
In the days leading up to the surgery, your doctor may:
You should also talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure.
Depending on which option is best for you, your doctor may give you:
If there are any skin tags near the fissure, they will be removed. Next, the doctor will carefully make a cut on the anal sphincter muscle. This will relax the sphincter and allow it to stretch, taking pressure off the fissure. The doctor will put a dressing into your anus to stop the bleeding.
Less than one hour
Anesthesetics will prevent pain during the procedure. Pain and discomfort after the procedure can be managed with medications.
You may be given pain medications and instructions for how to care for your rectal area. A nurse may change your dressing or instruct you on how to change it.
During your stay, the care center staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
When you return home, you will need to take steps to promote healing and prevent infection. These will include:
Your doctor may advise:
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
American Society of Colon and Rectal Surgeons
Family Doctor—American Academy of Family Physicians
Canadian Society of Colon and Rectal Surgeons
The College of Family Physicians of Canada
Anal fissure. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/anal_fissure. Updated October 2012. Accessed May 28, 2013.
Anal fissure. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 20, 2012. Accessed May 28, 2013.
Anal fissure treatments. University of Wisconsin School of Medicine and Public Health, UW Health website. Available at: http://www.uwhealth.org/healthfacts/surgery/5467.html. Updated April 24, 2013. Accessed May 28, 2013.
Anal fissures. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases_conditions/hic_Anal_Fissures. Updated April 19, 2010. Accessed May 28, 2013.
Anal fissures. University of California San Francisco Medical Center website. Available at: http://www.ucsfhealth.org/education/anal_fissures. Accessed May 28, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed January 2015 by Daus Mahnke, MDLast Updated: 5/8/2014