Cracks in the anus: how to treat anal fissures in adults and children
When there are anal fissures, how to treat them correctly, can tell only a specialist. What are they? Cracks in the anus are linear ruptures of the anal mucosa, through which feces come out from the intestine. Their symptoms are pain in the area of the rectum and perineum, which worsens during defecation. Since this is a fairly common disease, many patients come to the doctors with questions about how and what to treat the fissures of the anus.
Treatment of rectal fissures aimed at pain relief, treatment of constipation and softening stools. With a chronic rectal fissure, when symptoms persist for more than 6 weeks, surgery may be necessary.
Therapies anus
crack anal fissure - very painful and common disease, which gives a lot of trouble to the patient. Therefore, often people are wondering how to cure the fissure of the anus completely.
Like any rupture or incision on the skin, anal fissures often heal on their own, for several weeks. However, a person with this disease should always consult with a doctor who can advise for the treatment of drugs that alleviate the symptoms and accelerate the healing of the fissure of the anus.
Treatment of adult patients
To cure anal fissure, like many other diseases, it is possible at home. Nevertheless, the recommendations of the attending physician should be strictly observed, which, as a rule, are aimed at eliminating constipation and alleviating the symptoms.
Elimination of constipation allows the crack to heal faster and reduces the risk of their occurrence in the future.
Treatment of anal fissures home includes:
- Increasing the amount of fiber consumed daily by incorporating a sufficient amount of diet rich its products - fruits, vegetables, whole grain cereals and breads.
- Drinking enough water to avoid dehydration.
- Exercise - for example, walking or jogging.
- Developing the habit of going to the toilet at the same time.
- Do not delay visiting the toilet when there is a urge to empty the bowels.
- When using wet wipes to avoid those that contain fragrances or alcohol, as they may cause discomfort or itching.
- When using toilet paper, you should give preference to its soft types.
- necessary to wash the perineum and the anal area with warm water several times a day, especially after a bowel movement to relax the anal muscles, increase blood flow and clear without friction and skin irritation.
Doctors can also prescribe for treating cracks around the anus in adults medication different medicines that help relieve symptoms and allow them to heal faster.
Laxative preparations
These drugs help to facilitate bowel movement. In adults, in order to treat cracks in the anus from laxatives, drugs that increase the volume of feces are used. They help to keep in the lumen of the intestine more fluid, because of what the stool becomes soft and bulky.
doctor may recommend a lower starting dose of laxative drug, gradually increasing it over a few days until the patient will not be emptied soft stools every 1-2 days. Cured constipation is the key to getting rid of cracks.
Analgesics
If a person feels after defecation prolonged pain, the doctor may prescribe him painkillers - such as paracetamol or ibuprofen.
Nitroglycerin Ointment
If the symptoms of a crack in the anus are not improved within 1-2 weeks, the doctor can prescribe nitroglycerin for treatment as an ointment, which should be applied directly to the anal area, usually twice a day. Nitroglycerin dilates the blood vessels inside and around the anus, which helps improve blood flow to tissues and promotes faster healing of the fracture. It also reduces pressure in the anal canal, which should help relieve pain.
Most of the acute anal fissures that exist for less than 6 weeks, heal with the use of an ointment with nitroglycerin. With chronic cracks, the effectiveness of this drug is about 70%.
Since using nitroglycerin to treat anal fissures, it is absorbed into the systemic circulation through the hemorrhoidal veins, many patients may develop a headache. Some people may also feel dizzy. In such cases, it is necessary to reduce the amount of ointment applied.
Sometimes, using a smaller amount 5-6 times a day is easier to carry than applying more twice a day.
Local anesthetics
If a patient with a crack has severe pain in the anus, the doctor can prescribe for him local anesthetics in the form of ointments or suppositories. Apply them recommended immediately before emptying the intestine. Ointment should be applied directly to the affected area.
The drugs used to treat anal fissures are also often prescribed for exacerbation of hemorrhoids. These drugs do not accelerate the healing of a crack, but relieve pain. As a rule, they are used in the first 1-2 weeks.
Sometimes a small amount of a hormonal agent is added to the ointment with a local anesthetic, which reduces inflammation. The use of such ointments should last no longer than 2 weeks, as they can lead to thinning of the skin in the damaged area.
Calcium channel blockers
Usually used to treat arterial hypertension. Nevertheless, these drugs, applied directly to the anal area, are useful even for cracks in the anus. They relax the muscles-sphincters and improve the blood supply of damaged tissues.
Side effects of calcium channel blockers may include headaches, dizziness, itching, or burning sensation at the site of application. They usually pass for several days of use, as the patient's body gradually gets used to the treatment.
Topical application of calcium channel blockers is considered as effective as nitroglycerin, and can cure a rectal crack if other drugs have not helped.
Botulinum toxin injections
This is a relatively new method for the treatment of anal fissures, which is usually used in the inefficiency of all other methods of conservative therapy. Botulinum toxin is a very strong poison that can be safely used in small doses.
With an anal fissure, his injection causes paralysis of the sphincter muscles. This prevents their spasm, helps to reduce pain and speeds up the healing of a crack. The toxin is injected into the external and internal sphincters, as well as into the crack itself.
Doctors claim that injections of botulinum toxin help more than half the patients. Its action lasts 2-3 months, which is enough to heal the crack. The main side effect of this treatment is the weakness of sphincter muscles, which is manifested by incontinence, which, as a rule, is temporary.
A person who treats anal fissures at home should visit a doctor regularly who will evaluate the progress of recovery. If conservative methods are ineffective, proctologist advice and surgical treatment may be needed.
Operations are considered to be the most effective method, as doctors say, they can cure more than 90% of patients with an anal fissure. However, like any surgical intervention, these operations are accompanied by a small risk of complications.
For anal fissures, the following operations are performed:
- Lateral sphincterotomy. The procedure is to perform a small incision in the ring of sphincter muscles surrounding the rectum. This helps reduce the pressure inside the anus and allows the anal fissure to heal, and also reduces the risk of recurrence of the disease. Such an operation does not last long, it is relatively simple and is conducted, as a rule, under general anesthesia. Lateral sphincterotomy is one of the most effective methods of treating anal fissures, most patients recover completely within 2-4 weeks. In this operation, due to damage to the anal muscles, in 5% of patients, temporary fecal incontinence may develop. However, this complication is not severe and lasts only a few weeks.
- Excision of the anal fissure. This technique is used for chronic anal fissures.
Sometimes proctologists cover the surface of a crack with a flap of skin taken from a healthy area of the patient's body. This improves the blood supply to damaged tissues and promotes recovery.
Treatment of anal fissures in children
Cracks in the rectum in children are often enough, so many parents are interested in how to treat them.
As a rule, the treatment of cracks in the anus in children is based on the same principles as in adults. It is also aimed at eliminating constipation and softening the stool. This is achieved by introducing more fiber into the diet( provided that the age of the child is allowed), increasing water intake.
All tips for non-pharmacological treatment of a crack in the anus in an adult patient can be used in a child. These include baths with warm water, and physical exercises, and the development of the habit of visiting the toilet at a certain time in a comfortable environment.
Medical treatment of anal fissures in children is carried out only on the advice of doctors. Most often they prescribe :
- Laxatives. Young children, unlike adults, are more likely to be recommended osmotic laxatives, which increase the amount of fluid in the stool, thereby softening the stool and increasing its volume. The dose of drugs is calculated by the weight of the baby.
- Nitroglycerin Ointment. Calcium channel blockers.
- Ointments with local anesthetics.
- Injection of botulinum toxin. They are used only in extreme cases, with large and non-healing cracks, since the places of administration and dosage of this drug in children are not yet accurately established.
With anal fissures in children, surgical interventions are very rare - with ineffective conservative treatment and chronic fissures. The most commonly used lateral sphincterotomy and excision of chronic cracks.
Treatment of anal fissures in pregnant women
If cracks in the anus have occurred during pregnancy, treatment is based on non-pharmacological recommendations. For example, doctors advise these women to consume fiber-rich foods, drink plenty of water, exercise, take sedentary baths.
If these measures are not effective, local anesthetics can be used in the form of ointments, soft laxatives. It is better to abstain from using nitroglycerin ointment during pregnancy.
Surgical treatment of a crack in the anus is usually performed after delivery, if conservative therapy is ineffective.
Folk treatment of anal fissures
The most common folk remedies used to treat a rectal crack are:
- Olive oil. Rich in healthy fats, which lubricate the intestinal surface and facilitate its emptying. It can be injected directly into the rectum in an amount of 50 ml. Also a mixture of olive oil, honey and beeswax relieves pain, reduces bleeding and itching in the affected area. To obtain this mixture, its ingredients must be mixed in the bowl in the same proportion, then heated in a microwave oven so that the beeswax completely melts. After cooling the mixture, it should be applied to the damaged area several times a day.
- Aloe. Has healing and anti-inflammatory properties. It is necessary to cut one leaf from the plant, cut it along the entire length and squeeze out the juice. Then, apply a small amount of this juice to the affected area several times a day. Comfrey. This plant has healing properties, promotes the healing of anal fissures and alleviates pain. It is necessary to add 1 teaspoon dried comfrey in 1 cup of hot water, cover and insist 10-15 minutes, then allow to cool. This infusion should be used to cleanse the affected area 2-3 times a day.
How to distinguish a crack from a hemorrhoids?
Since hemorrhoids are considered the most common rectal disease, many people think that any pain in the anus is due to them. Nevertheless, it is necessary to know the differences between hemorrhoids and anal fissure, which also occurs very often.
It should be noted that, in the case of the anus fracture, acute, cutting pain occurs, appearing or increasing after defecation, in the patient's complaints. In ordinary hemorrhoids, people complain more often about blood liberation during defecation. Also, with this disease, often from the anus, hemorrhoids drop out, which makes it possible to distinguish it from anal fissures.
However, severe pain with hemorrhoids can develop with thrombosis of hemorrhoids. The pain in this case is very strong, has a permanent character.
To establish the correct diagnosis and give the correct recommendations, a doctor can refer to. In addition, it should be remembered that the presence of hemorrhoids does not deny the presence of anal fissure, but, conversely, - it contributes to its appearance.
Anal cracks are a very common cause of pain in the anus. For its treatment, it is necessary to eliminate constipation and reduce pain during defecation. In the case of ineffectiveness of conservative treatment, surgical intervention is performed.
Author: Taras Nevelichuk, doctor,
specially for Moizhivot.ru
