Anal Fissure

(Fissure in ano, Analulkus)

Under an anal fissure is meant an acute onset of longitudinal tear or a chronic oval ulcer in the anal canal squamous. It causes severe pain that sometimes v. a. connected during defecation with blood flow. The diagnosis is obtained by the inspection. Treatment consists of local hygiene, Stuhlaufweichern, topical action and occasionally Botulinumtoxininjektion and / or surgical procedures.

See also Evaluation of Anorectal Disorders and the American Society of Colon and Rectum Surgeons’ practice parameters for the management of anal fissures.)

Under an anal fissure is meant an acute onset of longitudinal tear or a chronic oval ulcer in the anal canal squamous. It causes severe pain that sometimes v. a. connected during defecation with blood flow. The diagnosis is obtained by the inspection. Treatment consists of local hygiene, Stuhlaufweichern, topical action and occasionally Botulinumtoxininjektion and / or surgical procedures. See also Evaluation of Anorectal Disorders and the American Society of Colon and Rectum Surgeons’ practice parameters for the management of anal fissures.) It is believed that anal fissures arise from a disaster caused by hard stool laceration or due to frequent unformed bowel movements. Trauma (such. As anal intercourse) is a rare cause. The fissure may cause a spasm of the internal sphincter and thereby reduce the blood supply and maintain the fissure. Symptoms and signs In the rule, the fissures in the rear center line, but can also occur in the anterior midline. Those who are not in the midline, often have a specific etiology, v. a. Crohn’s disease. At the upper end of the fissure an outer skin corner can (solitary nodules) occur at the lower end is an enlarged (hypertrophic) papilla. In children acute fissures can arise chronic are rare. Chronic fissures must be separated from the differential diagnosis carcinoma, primary lesions in syphilis, tuberculosis and ulceration in Crohn’s disease. Fissures cause pain and bleeding. The pain typically appear with or shortly after defecation, lasts several hours and diminishes until the next bowel movement. The test must be done carefully with adequate spreading of the anus in order to have proper perspective. Anal fissure BSIP / SCIENCE PHOTO LIBRARY var model = {thumbnailUrl: ‘/-/media/manual/professional/images/c0044711-anal-fissure-science-photo-library-high_de.jpg?la=de&thn=0&mw=350’ imageUrl ‘/-/media/manual/professional/images/c0044711-anal-fissure-science-photo-library-high_de.jpg?la=de&thn=0’, title: ‘fissure’, description: ” credits’ BSIP / SCIENCE PHOTO LIBRARY ‘, hideCredits: false, hideTitle: false, hideFigure: false, hideDescription: true}; var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘image-element-panel.’). ko.applyBindings (model, panel.get (0)); Diagnosis Clinical examination obtained the diagnosis of anal fissure through the inspection. If the findings do not suggest a specific cause or the appearance and / or the location are unusual, no further testing is required. Therapy Stuhlaufweicher Protective ointments, sitz baths nitroglycerin ointment, topical calcium channel blocker, or an injection of botulinum toxin type A (See also the Cochrane summary: nonsurgical and surgical therapy for anal fissure.) Fissures often respond to conservative measures, the damage during defecation minimize (Stuhlaufweicher, psyllium, dietary fiber). The cure is protective zinc albums or mild suppositories (eg., Glycerol), who wet the lower rectum and soften the stool. Local anesthetics (eg. As benzocaine, lidocaine) and warm (not hot) sitz baths for 10-15 min after each stool, or as needed provide temporary relief. Local 0.2% nitroglycerin, 0.2% Nifedipincreme, 2% Diltiazemgel and injections of botulinum toxin type A in the internal sphincter can be the anal sphincter relaxes, reduce the maximum resting anal pressure and allow healing. If conservative measures do not lead to the goal, operative intervention (internal anal sphincterotomy or controlled dilation of the anus) is required in order to break the vicious circle of the internal Analsphinkterspasmus.

Health Life Media Team

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