Brief Answer:
Diet modification and local therapy will help
Detailed Answer:
Namaste
Welcome to Healthcare-Magic
Greetings of the day
I will first try to answer all your questions first and explain you at end of it.
1. Yes it's possible for chronic
fissure in ano to heal with non surgical management
2. Psychological symptoms are.due to
chronic pain and discomfort associated with it
3. Best way to avoid stiffness in morning is by avoiding
constipation and local application of smooth
muscle relaxant like Nifedepine or
Nitroglycerin 15 to 20 prior to resting to restroom.
I would like to impress a very important thing which I tell all my patients, treatment of chronic fissure in ano requires lot of patients and perseverance on the part of patient and religiously sticking to treatment and lifestyle modifications like diet change. It's worth the attempt you will be putting.
Aim of treatment is
1. Prevent Constipation- it's very important to that as any constipation will promote further tear and will lead to recur.It's one of the very important modality of treatment
2. Relaxing the Internal sphincter and relieving local pain - it's very important to do this as it will help prevent stress on ulcer and help in healing.
I would suggest you the following which will go a long way in curing your, it will definitely help in your case as it's helped many of my patients
1. Drinking sufficient water - consume atleast 2 to 3 liter of water everyday. It will prevent constipation and will help the fiber in diet to absorb water and form formed smooth stools.
2. Intake of high fiber diet - consumption of natural foods containing high fiber is advisable especially cucumber, beetroot, citrus fruits and other fruits. ( eat whole fruits instead of fruit juices, fruits contain pectin which is good natural fiber-they get filtered out in juices)
3. Avoid constipating diet
4. Supplements of fiber like cellulose may help.
5.. local application of mixture of
local anaesthetic like Xylocaine and
smooth muscle relaxant like Nifedepine applied 15 to 20 minutes before resting to restroom room will relax the spasm and prevent pain of defecation. Hot Seitz bath after defecation and 're application of mixture will be.helpful.
I suggest you to make all this a regular habit and sure you will be relieved of your symptoms.
Wishing you healthy and happy life
If you need any further assistance will be glad to assist you
Take care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCh
Consultant Surgeon