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Suggest Treatment For Chronic Anal Fissure
Question: dear doctor,
I m a 36yrs old male diagonised with chronic anal fissure a yr ago. The last treatment with GTN was a failure n the consulting doctor suggested surgery 4 months ago.
Fearful of surgery I havent been taking any medications ever since n made changes to diet habits. This has helped me with less painful bowel movements as thy are mostly soft.
The cause of worry is the spasms tht sometimes makes sittin in one position difficult and recur almost daily.
I hav been told thts spasms will only go after surgery. if surgery is the last option for me. Wat care should i tk post surgery to improve my healing chances n bring normalcy in my life.
Thnxs
XXXX
I m a 36yrs old male diagonised with chronic anal fissure a yr ago. The last treatment with GTN was a failure n the consulting doctor suggested surgery 4 months ago.
Fearful of surgery I havent been taking any medications ever since n made changes to diet habits. This has helped me with less painful bowel movements as thy are mostly soft.
The cause of worry is the spasms tht sometimes makes sittin in one position difficult and recur almost daily.
I hav been told thts spasms will only go after surgery. if surgery is the last option for me. Wat care should i tk post surgery to improve my healing chances n bring normalcy in my life.
Thnxs
XXXX
Brief Answer:
Botulinum injections can stop the spasms.
Detailed Answer:
Hello!
Thank you for the query.
Spasms can be stopped with Botulinum injection into rectal muscle. This should help with fissure as well and can make surgery not necessary. So I do not think surgery is the last option for you.
Post surgery you need to make a good environment for proper wound healing. To do that, liquid diet and stool softeners should be started. Sitz baths with Oak Bark, regular rectum washing and avoiding pushing on stool should help with proper healing.
Healing process usually takes a week in this area. There might be a strong pain in the first day after surgery. It can be eased with pain killers.
Hope this will help. Feel free to ask further questions.
Regards.
Botulinum injections can stop the spasms.
Detailed Answer:
Hello!
Thank you for the query.
Spasms can be stopped with Botulinum injection into rectal muscle. This should help with fissure as well and can make surgery not necessary. So I do not think surgery is the last option for you.
Post surgery you need to make a good environment for proper wound healing. To do that, liquid diet and stool softeners should be started. Sitz baths with Oak Bark, regular rectum washing and avoiding pushing on stool should help with proper healing.
Healing process usually takes a week in this area. There might be a strong pain in the first day after surgery. It can be eased with pain killers.
Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
hello doctor
thnx for reply.
Unfortunately for me Botox treatment in this country is not available.
A friend suggested diltiazem ointment.
do u think i shud try this?
Also i hav been advised not to delay surgery as chances of healing and recovery are better earlier. In later stages mayb there can be complications.
The spasms started 4 months earlier after stopping GTN treatment and hav been having thm since.
if any alternative to botox is available. kindly suggest.
regards
XXXX
thnx for reply.
Unfortunately for me Botox treatment in this country is not available.
A friend suggested diltiazem ointment.
do u think i shud try this?
Also i hav been advised not to delay surgery as chances of healing and recovery are better earlier. In later stages mayb there can be complications.
The spasms started 4 months earlier after stopping GTN treatment and hav been having thm since.
if any alternative to botox is available. kindly suggest.
regards
XXXX
Brief Answer:
Surgery can be daleyed few months.
Detailed Answer:
Dilitiazem can be tried. It is a good idea.
Well, delaying surgery for few months wont change anything. It just a wound in the rectal area. It stays the same all the time (unhealed). It is true that waiting too long (like few years) can cause some scar in this area and make it really narrow.
No other known methods of treatment than mentioned above and in our previous conversation.
So to make it simple, try Dilitiazem for few weeks and see if it will help or not. If no improvement, go for the surgery.
Regards.
Surgery can be daleyed few months.
Detailed Answer:
Dilitiazem can be tried. It is a good idea.
Well, delaying surgery for few months wont change anything. It just a wound in the rectal area. It stays the same all the time (unhealed). It is true that waiting too long (like few years) can cause some scar in this area and make it really narrow.
No other known methods of treatment than mentioned above and in our previous conversation.
So to make it simple, try Dilitiazem for few weeks and see if it will help or not. If no improvement, go for the surgery.
Regards.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Doctor
Can u mention the dosage for this ointment, like hw many times a day. And for how many weeks?
will there be side effects i should be aware.
regards,
XXXX
Can u mention the dosage for this ointment, like hw many times a day. And for how many weeks?
will there be side effects i should be aware.
regards,
XXXX
Brief Answer:
Dilitiazem should be used twice a day for 8 weeks.
Detailed Answer:
Dilitiazem ointment should be used twice a day for 6-8 weeks. It should not give any side effects as you use it only in rectal area. In some cases blood pressure drop or face redness can appear. But this is rare.
Regards.
Dilitiazem should be used twice a day for 8 weeks.
Detailed Answer:
Dilitiazem ointment should be used twice a day for 6-8 weeks. It should not give any side effects as you use it only in rectal area. In some cases blood pressure drop or face redness can appear. But this is rare.
Regards.
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Above answer was peer-reviewed by :
Dr. Prasad
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