Treatment of fissure in allahabad - www.ksharsutraallahabad.com

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• फ़िसर के सामान्य लक्षणो मे दर्द,चुभन व जलन प्रथम है तदोपरान्त खुजली भी हो सकती है|
• रक्त का स्राव मल के ऊपर रेखा के रूप में अथवा बून्दो के रूप में हो सकता है अथवा नही भी हो सकता है|
• मलत्याग के तत्काल बाद ही दर्द,चुभन व जलन इत्यादि मे वृद्धि हो जाती है|
• कई बार पूय / मवाद का स्राव भी होते देखा गया है|
• फ़िसर के कारणो मे दोपहिया वाहन की अधिक सवारी, कठोर मल (Hard Stool)का त्याग , अधिक देर तक बैठने वाला कार्य इत्यादि शामिल है|
• फ़िसर कि चिकित्सा सामान्यतया औषधियो द्वारा की जाती है एवं 50% से अधिक रोगियो मे, यदि चिकित्सक योग्य है तो ऑपरेशन की आवश्यकता नही पड़ती है| 

CAUSES OF FISSURE:

# common in young and middle age groups.The disease sometimes is seen in children and infants too.

#Constipation:it is the main factor for occurrence of repeated anal fissure after complete healing. # Incidence of anterior anal fissure is high in women during parturition.

#PROLONG USE OF PURGATIVES :The long and regular use of purgative for soft and liquid stool causes contraction of the anal canal .So sometimes during passage of hard stool ,the  cutaneous lining of anal canal becomes stretched causing single or multiple fissures or erosions in lower anal canal.

#SPASM OF ANAL SPHINCTERS : The septic materials in the pocket of the anal fissure are retained by the spasm of the anal musculatures.So inadequate drainage of fissure delays the healing process.Thus the fissure becomes chronic and nonhealing.

#OTHER CAUSE OF FISSURE: Removal of excessive tissues of anal canal during haemorrhoidectomy causes anal stenosis and fissures during passage of hard stool.Inflammatory bowel syndrome like Proctocolitis or colitis of various origin,crohn’s disease,anal venereal disease severe attack of diarrhea or dysentery causes tearing of anal skin due to repeated stool and inflammation of anal canal.

FISSURE SYMPTOMS:  

Pain: It is the most prominent symptom of anal fissure.Sharp cutting,burning,tearing pricking or dull aching occurs during defecation,which persists for 2-3 hours more after act.The patient is frightened to go for defecation and remains constipated for many days.

Bleeding:A streak of bright red blood with faecal column is the feature of anal fissure.Occasionally moderate to severe bleeding may occur which causes marked anaemia with symptoms of acute or chronic blood loss.

Swelling : In chronic cases a sentinel tag at the base of anal fissure develops.It may become infammed and patient complains for painful external pile.

Discharge and Pruritus: The perianal region is soiled with traces of purulent discharge from chronically inflamed anal fissure.Sometimes purulent discharge from anal fistula behind the tag is seen.The discharge causes itching and burning at anal and perianal region and oedema of local skin and tag.The underclothes become stained with purulent discharge.

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