Fissure Treatment Specialist in Pune

Advanced treatment options for acute and chronic fissures

What is an Anal Fissure?

An anal fissure is a small tear or ulcer in the sensitive tissue lining the anal canal. It typically causes severe pain during and after bowel movements, often accompanied by bright red bleeding. While generally not dangerous, fissures can significantly impact quality of life.

Anal fissures can be acute (recent) or chronic (persistent), with each requiring different treatment approaches.

Acute vs Chronic Fissures

Acute Fissures

Duration: Less than 6 weeks
Usually with jagged edges
Caused by trauma or constipation
60-70% heal with conservative care
Responds well to medications

Chronic Fissures

Duration: More than 6 weeks
Deep, well-defined edges
Associated muscle spasm
Require active treatment
Medications alone often fail

Symptoms of Fissure

Sharp Pain: Intense, tearing pain during bowel movements, often lasting hours afterward

Bleeding: Bright red bleeding on toilet paper or stool

Spasm: Anal sphincter muscle spasm causing cramping

Itching: Persistent itching in and around the anus

Visible Tear: Small visible tear in anal tissue

Causes of Fissure

Primary Causes

Chronic constipation
Straining during bowel movements
Hard or large stools
Childbirth trauma
Chronic diarrhea

Contributing Factors

Low fiber diet
Dehydration
Anal sphincter spasm
Inflammatory bowel disease
Anal trauma

Diagnosis of Fissure

Dr Kundan Kharde diagnoses anal fissures through:

Clinical Examination: Visual inspection and gentle digital examination
Anoscopy: Visualization with specialized scope if needed
Pain History: Understanding timing and severity of pain
Differentiation: Ruling out other conditions like piles, fistula, or IBD

Treatment Options for Fissure

1. Topical Medications

Nitroglycerin, calcium channel blockers, or local anesthetics reduce pain and improve blood flow.

2. Botulinum Toxin (Botox)

Injection relaxes anal sphincter, reducing spasm and pain. Effective in 80-90% of cases.

3. Laser Therapy

Low-level laser therapy improves healing and reduces pain without surgery.

4. Lateral Internal Sphincterotomy (LIS)

Surgical division of a portion of anal sphincter muscle for permanent relief of spasm.

Recovery & Healing

Conservative Treatment (Medications): 2-4 weeks for healing. High-fiber diet and stool softeners essential.

Botox Treatment: Pain relief within days. Complete healing in 2-3 weeks.

Laser Therapy: Gradual healing over 4-6 weeks. Pain reduction within days.

LIS Surgery: Recovery in 2-3 weeks. Complete healing in 4-6 weeks.

When to Seek Treatment

Consult Dr Kundan Kharde if you experience persistent anal pain, bleeding lasting more than a week, or symptoms not improving with home care after 2 weeks.

Book Appointment

Consult with Dr Kundan Kharde for personalized treatment.

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Other Treatments Available

Piles Treatment

Fistula Treatment

Laser Piles Surgery

Understanding Anal Fissure

An anal fissure is a tear in the anal lining, often posterior midline. Typical symptoms include severe pain during and after bowel movements and bright bleeding. Acute fissures may heal with medical therapy; chronic fissures may need procedures such as botulinum toxin, lateral internal sphincterotomy, or laser-assisted techniques.

Causes and examination

Constipation, hard stools, and prolonged straining are common triggers. Diagnosis is clinical; examination excludes abscess or fistula when symptoms suggest.

Treatment pathway

Stepwise care starts with stool softening and topical therapy. If healing stalls, minimally invasive options are discussed with clear explanation of benefits and risks.

Recovery and prevention

Sitz baths, fibre targets, and follow-up ensure healing. Prevention focuses on avoiding constipation and treating diarrhoea promptly.

Frequently Asked Questions

What is an anal fissure?

An anal fissure is a small tear in the tissue lining the anus, usually caused by trauma during bowel movements or severe constipation.

What is the difference between acute and chronic fissures?

Acute fissures last less than 6 weeks and often heal with conservative care. Chronic fissures persist beyond 6 weeks and require active treatment.

Is anal fissure treatment painful?

Modern treatments like Botox, laser, and LIS are minimally invasive with minimal pain. Medications are non-invasive.

Can anal fissures heal on their own?

Acute fissures may heal with high-fiber diet and stool softeners (60-70% success). Chronic fissures need treatment.

What is Botox injection for fissures?

Botox relaxes the anal sphincter muscle, reducing pain and spasm, allowing the fissure to heal naturally.

How long does recovery take after LIS surgery?

Recovery from LIS (Lateral Internal Sphincterotomy) takes 2-3 weeks. Most patients return to work within a week.

Are there any serious complications?

Serious complications are rare. LIS may rarely cause incontinence (1-2%). Infection and bleeding are also uncommon.

Can fissures recur after treatment?

Recurrence is possible (10-15%) if constipation persists. Maintaining soft bowel movements is key.

This procedure is performed at Sharvari Hospital

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