Anal Fissure – Modern Treatment for Pain-Reduced Healing
Overview
- Causes: Anal fissures often arise from hard stools, excessive straining, chronic constipation, or recurrent diarrhea.
- Symptoms: Severe pain during bowel movements, burning sensation, bright red bleeding, and a spasmodic closure of the sphincter.
- Diagnostics: Medical history, physical examination, and careful proctological examination.
- Treatment options: Stool regulation, ointments, sitz baths, botulinum toxin, as well as surgical and laser-assisted procedures.
- Advantages of laser therapy: Precise treatment of the fissure, preservation of the sphincter, minimal bleeding, and minimally invasive approach.
What is an Anal Fissure?
An anal fissure is a longitudinal tear in the mucosa of the anal canal. It is one of the most common painful conditions in the rectal area and can occur both acutely and chronically. Typical symptoms include severe pain during or after bowel movements and bright red bleeding.
If an anal fissure remains untreated or does not heal completely, it can become chronic and maintain symptoms over a longer period.
What Symptoms Does an Anal Fissure Cause?
The symptoms often appear suddenly and can significantly impair quality of life.
Common Symptoms
- severe pain during or after bowel movements
- burning sensation in the anal area
- bright red blood on toilet paper
- spasmodic contraction of the sphincter muscle
- itching
- difficulty in bowel movements due to pain
How Does an Anal Fissure Develop?
An anal fissure usually develops due to overstretching of the sensitive mucosa in the anal canal.
Common causes include:
- hard bowel movements
- chronic constipation
- intense straining
- recurrent diarrhea
- inflammatory bowel diseases
- less commonly, injuries or surgical procedures
The pain often creates a vicious cycle: the sphincter muscle cramps, blood circulation worsens, and healing is hindered.
How is an Anal Fissure Diagnosed?
The diagnosis is usually made based on the typical symptoms.
The examination includes:
- comprehensive medical history
- inspection of the anal area
- careful proctological examination
- proctoscopy if needed
What Treatment Options Are Available?
Treatment depends on whether an acute or chronic anal fissure is present.
Conservative Treatment
- fiber-rich diet
- adequate fluid intake
- stool regulation
- sitz baths
- pain-relieving or muscle-relaxing ointments
- botulinum toxin in selected cases
Surgical Treatment
If a chronic anal fissure does not heal despite conservative measures, surgical treatment may be necessary.
Laser Therapy for Anal Fissures
Laser therapy is a modern option for treating chronic anal fissures. The fissure is gently treated using laser energy. Simultaneously, targeted heat application in the area of the internal sphincter muscle can reduce its tension without surgically cutting the muscle.
Our procedure allows for a fissurectomy without tissue excision. At the same time, bleeding can be minimized, and the need for additional hemostasis reduced, while the sphincter muscle is maximally preserved.
What Are the Advantages of Laser Therapy?
Advantages at a Glance
- minimally invasive procedure
- precise treatment of the anal fissure
- preservation of the sphincter muscle
- minimal bleeding
- often no tissue excision required
- short recovery time
After the Treatment
After the procedure, a fiber-rich diet, adequate hydration, and good anal hygiene are important to support healing. The treating proctologist will discuss which follow-up measures are appropriate individually with the patient.