Perianal Fissure (Breech Crack)
Perianal Fissure (Breech Crack)

What is it?

Wounds that develop in the anus, especially after trauma, are called perianal fissures. These wounds may vary from ulcers with deep pits to linear skin openings. The most common cause is the destruction caused by the faeces coming out with high pressure in case of diarrhoea and constipation. Cracks often occur in the lower centre line.

Who is it common in?

Individuals with high-pressure defecation such as chronic diarrhoea, constipation, injuries that develop after rectal drug administration and instruments used for examination in that area cause skin injury and fissure formation.

What are the Symptoms?

Red coloured bleeding and pain that starts with defecation and continues throughout defecation are the most common symptoms.

How is the diagnosis made?

In physical examination, the ruptured area is seen directly with the patient’s slight straining and the diagnosis is made.

How is it treated?

The most common treatment worldwide is LIS, that is, Lateral Internal Sphincterotomy, which is performed by cutting the muscles that hold the large ablution in the anus. The biggest problem of this surgery is that the muscles that provide faecal control are irreversibly cut and the control container is experienced in the future. Fecal incontinence, which we call faecal incontinence, is common in this patient group, especially in later ages.

What is Treatment with Botox?

Botox can be applied to this area instead of cutting the muscles in the surgery called LIS, Lateral Internal Sphincterotomy. Botox provides relaxation of the muscle and prevents injury and provides a suitable environment for the healing of the existing wound. The muscle cannot contract as before and remains in a relaxed state for an average of 4-6 months. During this period of time, the patient can perform large ablutions more easily and the wound heals faster.

Post-Treatment Follow-up and Diet

Patients who have undergone fissure treatment are called for a control examination after 5-7 days. Correction of eating habits, personal hygiene and water consumption are very important. It should not be forgotten that if our water consumption is low and our eating habits are wrong, solid faeces and the crack of the anus area due to this will recur.

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