Patients with anal fissures can engage in appropriate exercise, but they must be careful not to perform a large amount of stimulating activities to avoid adverse effects on the condition. Although anal fissures are common, their treatment should not be neglected.
1. Conservative Treatment for Anal Fissures: There are many treatment methods for anal fissures, and conservative treatment is generally the first choice. If conservative treatment is ineffective and results in chronic anal fissures, surgical resection should be considered.
1. Fresh Anal Fissures: Non-surgical methods can achieve healing, such as local hot water baths and post-defecation sitz baths with a 1:5000 potassium permanganate solution, which can promote relaxation of the anal sphincter. Anti-inflammatory and analgesic ointments (containing tetracaine, berberine, metronidazole, etc.) can be applied to the ulcerated area to promote healing. Laxatives can be taken to soften and lubricate the stool. For severe pain, local blockade or retention enemas with procaine can be used to relax the sphincter.
2. Chronic Anal Fissures: If the above treatments are ineffective, surgical resection can be performed, including the removal of ulcers and skin tags (sentinel piles). Partial external sphincter fibers can also be cut to reduce postoperative sphincter spasms and facilitate healing. The wound is not sutured, and postoperative care includes maintaining smooth bowel movements, hot water baths, and wound dressings until complete healing. In recent years, liquid nitrogen cryotherapy for anal fissure resection has shown satisfactory results, with minimal postoperative pain, no wound bleeding, and no anal incontinence.
If anal fissure pain symptoms occur, patients can visit a hospital to receive an injection of 1%-2% procaine into the sphincter, injected at the base of the fissure and within the bilateral anal sphincters, to relieve the pain. For acute or chronic anal fissures without complications such as papillary hypertrophy and sentinel piles, anal canal dilation can be selected. Anal canal dilation under local anesthesia or sacral canal anesthesia can relieve sphincter spasm and achieve pain relief.
