FISSURE

Diagnosis

Your doctor will likely ask about your medical history and perform a physical exam, including an ¬†inspection of the anal region. Often the tear is visible. Usually this exam is all that’s needed to diagnose an anal fissure.

An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has a deeper tear, and may have internal or external fleshy growths. A fissure is considered chronic if it lasts more than eight weeks.

. Your doctor may recommend further testing if he or she thinks you have an underlying condition:

An anoscope is a tubular device inserted into the anus to help your doctor visualize the rectum and anus.

Services

Treatment

Nonsurgical treatments

Your doctor may recommend:

  • Topical anesthetic creamssuch as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.

Surgery

If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing.

Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence.