Anal fissures are a common yet often misunderstood condition that can cause significant discomfort and anxiety. To shed light on this topic, we sat down with Dr. Preethi Mrinalini, a renowned gastroenterologist and surgeon at Marinas Clinic, widely recognized as the best female surgeon in Chennai. Dr. Preethi Mrinalini has treated countless patients with anal fissures and offers a wealth of knowledge on the most effective treatments and preventive measures.
Understanding Anal Fissures
An anal fissure is a small tear in the lining of the anus, which can cause pain and bleeding during bowel movements. It’s a condition that can affect people of all ages, but it’s particularly common in young adults and middle-aged individuals. The most typical cause is the passage of hard or large stools, but chronic diarrhea, inflammation, and even childbirth can contribute to the development of fissures.
Dr. Preethi explains, “Anal fissures often present with symptoms such as sharp pain during defecation, followed by a burning sensation that can last for hours. Some patients also notice bright red blood on the toilet paper or in the stool.” These symptoms can be distressing, leading many to seek medical attention, sometimes even assuming they might have more serious conditions like hemorrhoids or colorectal cancer.
Initial Treatments and Lifestyle Modifications
When asked about the first steps in treating anal fissures, Dr. Mrinalini emphasized the importance of lifestyle modifications. “The initial treatment for most patients involves dietary changes to soften stools and reduce straining during bowel movements,” she says. A diet rich in fiber, coupled with adequate fluid intake, can significantly reduce the risk of fissures recurring.
Dr. Preethi also recommends the use of stool softeners and bulk-forming agents like psyllium husk, which can help in making bowel movements less painful. “Regular exercise and avoiding prolonged sitting can also play a role in preventing anal fissures,” she adds.
Topical Treatments and Medications
For patients who do not respond to lifestyle changes alone, Dr. Mrinalini often prescribes topical treatments. “Nitroglycerin ointment is a common first-line treatment,” she explains. “It helps to increase blood flow to the area, which can promote healing and reduce pain.” Other topical treatments include calcium channel blockers, which also relax the anal sphincter muscle and improve blood flow.
Dr. Preethi notes that these treatments are generally effective, but they need to be used consistently. “Patients must apply these ointments as directed, usually for several weeks, to achieve the best results. If the pain is severe, I may also prescribe analgesics or recommend sitz baths to provide relief.”
When Surgery Becomes Necessary
While most anal fissures can be managed with non-surgical treatments, some cases require surgical intervention. “Surgery is usually reserved for chronic fissures that haven’t healed despite other treatments or for those that cause severe pain,” Dr. Preethi says. The most common surgical procedure is lateral internal sphincterotomy, where a small portion of the anal sphincter muscle is cut to reduce spasm and pain, allowing the fissure to heal.
“Sphincterotomy has a high success rate, with most patients experiencing relief within a few weeks,” Dr. Preethi explains. However, she also points out that, like any surgery, it carries risks. “There’s a small risk of incontinence, especially if the procedure isn’t performed correctly. That’s why it’s crucial to choose an experienced surgeon.”
Post-Treatment Care and Prevention
Post-treatment care is vital for ensuring a full recovery and preventing recurrence. Dr. Mrinalini advises her patients to continue with a high-fiber diet and stay hydrated even after their fissure has healed. “It’s important to maintain these healthy habits to avoid future issues,” she says. She also recommends regular follow-ups to monitor healing and address any concerns.
Dr. Preethi emphasizes the importance of being attentive to the early signs of anal fissures. “If you notice any symptoms like pain during bowel movements or blood in your stool, don’t hesitate to seek medical advice. Early treatment can prevent complications and the need for surgery.”
Conclusion
Anal fissures can be painful and distressing, but with the right treatment and care, they can be effectively managed. Dr. Preethi Mrinalini, who practices at Marinas Clinic and is regarded as the best female surgeon in Chennai, has extensive experience in treating this condition. Her insights highlight the importance of early intervention, lifestyle changes, and, when necessary, surgical options for achieving relief and preventing recurrence. For anyone experiencing symptoms, consulting with a qualified surgeon is the first step toward a pain-free future.