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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Anal Fissure, Diarrhea. Taken Nifedipine. Is Physiotherapy The Only Treatment?

I am a 54 y o male. I have a posterior anal fissure since april 8th following a violent diarrhea . Almost 6 months so far. I have used nifedipine for 6 weeks, but the wound did not heal. I underwent a colonoscopy and nothing was found. Tested for HIV , syphilis, parasites and tubercolosis. All negative. I have not a hypertonic internal sphincter according to two anal manometry I underwent. Those two exams (I did not trust the doctor that performed the first one) showed paradoxical reflex. My doctor refuses to do the sphicterotomy because he fears I may develop fecal incontinence. He told me to look for another opinion. Another doctor said that anal fissure caused by diarrhea are typical of paradoxical reflex, and that the only treatment available for this is physioterapy (biofeedback). I could not find this in medical literature. What do you think?
Mon, 7 Oct 2013
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General & Family Physician,  's  Response
Hello,
Thanks for the query to H.C.M. Forum.
Anal fissure is curable with conservative treatment as by the use of various dilators with a special method , You can also use it as I advise my patient from last many with success.
If size is very small and 4-5 cm above anus opening it can tried with success.
Good luck. Dr. HET
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Have Anal Fissure, Diarrhea. Taken Nifedipine. Is Physiotherapy The Only Treatment?

Hello, Thanks for the query to H.C.M. Forum. Anal fissure is curable with conservative treatment as by the use of various dilators with a special method , You can also use it as I advise my patient from last many with success. If size is very small and 4-5 cm above anus opening it can tried with success. Good luck. Dr. HET