An anal fissure is an open tear at the opening of the anus, usually at the back but sometimes at the front. It causes spasm of the sphincter muscle and substantial pain, which often gets worse over time. The pain can be severe when you open your bowels and linger long afterwards.
The spasm cycle
The muscles have to relax before a fissure can heal, and the internal anal sphincter is the part that struggles most. Spasm makes bowel motions painful, the pain causes more spasm, and the fissure stays open. Breaking that cycle is the point of treatment.
When surgery is considered
If Rectogesic ointment has not stopped the spasm, or you cannot tolerate its side effects, surgery may be recommended. It is most often needed for fissures that have been present for at least six weeks. Many fissures heal on their own within a few weeks, but chronic ones can persist far longer.
What the operation does
A small, controlled cut is made in the internal anal sphincter. This stops the spasm, reduces the need to strain, and makes bowel motions much less painful, which in turn allows the fissure to heal. Fissures are most common between the ages of 15 and 40, but the procedure works at any age.
Professor El-Khoury will talk through the operation with you in the rooms, covering why it is being recommended, what it involves, the risks and the benefits. He also provides Royal Australasian College of Surgeons information sheets on the procedure so you can read them at home and bring questions back.
This page is general information, not medical advice. What applies to you depends on your history, your examination and your results. Bring your questions to the consultation.