People suffering from hemorrhoids become more and more, and it affects not only the elderly, but also people of a young age. Without doing their own health, people subject themselves to various complications due to an untreated disease.
One of them is the cracks of the anus - defect of the mucous membrane. This disease often affects women of young and middle age, men are less likely, children are very rare.
Contents of
- Concept of anal fissure and its causes
- Surgical treatment of
- Indications and contraindications for operation
- Procedure of
- procedure Post-operation rehabilitation
- Opinion of victims
Anal fissure and its causes
An anal fissure in the acute stage brings not only discomfort to the patient, but alsostrong pains that interfere with the normal emptying of the intestine and the maintenance of a habitual way of life.
Cracks in the rectum, are longitudinal ruptures, ulcerous or erosive lesions of the mucous anus.
They come in different shapes: an oval, elongated triangle, oblong. Also differ in size: from 0.5 to 2.5 cm. It happens that cracks appear as an independent disease, regardless of whether the patient has hemorrhoids.
There are a lot of reasons for the formation of cracks.
The following prerequisites are distinguished here:
- prolonged constipation or chronic diarrhea;
- is a sedentary lifestyle;
- chronic or acute hemorrhoids;
- alcohol abuse and addiction to spicy foods;
- mechanical trauma to mucosal walls;
- heavy physical labor, weight lifting;
- some gastrointestinal diseases.
In order not to provoke such problems in oneself, a person must protect himself from the above situations.
Surgical treatment of
When conservative treatment of an anal fissure does not help, there is a need for surgical intervention.
There are two types of excision of anal fissures:
- classical excision;
- minimally invasive methods: electrocoagulation, electroradiosurgical coagulation and laser surgery.
Both methods are not considered complex and last no more than 15 minutes. From the characteristics of the disease and the state of the patient depends on where it will take place: in a hospital or polyclinic, under local anesthesia or under anesthesia.
Preparation for the operation includes the delivery of tests, specialist advice, compliance with the diet 2 days before the operation, cleansing enemas before the operation and hygienic procedures.
Indications and contraindications for operation
Surgery is indicated in the absence of a positive effect of conservative treatment for more than two weeks and with chronic anal fissures.
A crack from the acute form becomes chronic, if it is not treated, or the treatment has not yielded results. Surgery for excision is prescribed for complications: purulent inflammation, for example.
It is not recommended to perform an operation to excise cracks during infectious or viral diseases, with some skin lesions.
Process of procedure
Depending on the type of excision, the principles of its implementation may differ significantly.
Here you can consider the following aspects:
- The classical scheme of operation - such operation is done in stages. Initially, the patient is given general anesthesia to avoid
pain shock. Then the sphincter of the anus is dissected for free passage of the stool and normal healing of the wound. In the future, the surgeon cuts out the edges of the crack and removes the granulation on its bottom, while the wound remains open. After 5-6 days, the wound is healed, during which post-operative pain is present. - Electrocoagulation is the process of cauterizing tissues with diathermic current using high temperatures. Thanks to the device, the fracture tissues are excised and immediately the incised vessels are incinerated. Therefore, bleeding during this operation is absent, as a result of which there are no gross scars.
- Electrosurgical coagulation is a more popular operation than the previous one. It is done with the help of high-frequency radio waves. The wave beam is directed to the crack site, as a result of their action in the tissues, resistance is created, accompanied by an "explosion" inside the cells and release of thermal energy. It is warm and melts the pathological tissue of the crack. The operation lasts for a short time, is absolutely bloodless, there is minimal tissue damage, which leads to rapid healing and there is no post-operative pain.
- Laser surgery is the impact on the affected tissue of a crack by a laser beam. A beam of laser light directed to the tissue of the crack coagulates the protein and the defect of the site is eliminated. The operation is performed on an outpatient basis, does not last long, but the cracks appear again.
The choice of procedure depends on the outcome of the patient's examination. So, the expert on the basis of results of inspection can offer the patient possible variants.
Rehabilitation after operation
Regardless of the chosen method, they are all well tolerated by patients and have no significant contraindications.
But postoperative conservative treatment is mandatory for everyone.
Rehabilitation after excision of the rectal fissure will help rapid healing and exclude inflammatory processes.
Doctors recommend postoperative pain relief with analgesics and soothing baths.
Special attention should be paid to nutrition, personal hygiene and compliance with the regime, which the doctor recommends.
It is important to set the bowel movement so that the stool is daily and, best of all, the morning. To do this, include in the diet of sour-milk products, fish, poultry, meat. Milk is not consumed - it can lead to an intestinal disorder.
On the third day after the operation, it is recommended to eat baked apples and boiled vegetables, because the body needs fiber to prevent constipation. Fresh fruit without pits can be consumed 2 weeks after the operation.
For two months all spicy, smoked, spicy and alcoholic beverages are prohibited.
Refuse enemas and laxatives if you used them before surgery to ease defecation. Do not use toilet paper, use gauze wipes or wash with cool water.
For early wound healing and anesthesia, it is recommended to take sedentary baths twice a day with decoction of chamomile or solution of potassium permanganate.
The procedure should not be more than 15 minutes, after which the perineum is soaked with a gauze cloth. Baths stimulate wound healing, as blood circulation in the anus area improves, and the wound is cleaned.
Opinion of victims
Comments of operated patients who underwent excision of anal fissure in one way or another.
I was sick of this disease since I was 18 years old. I'm a girl, I did not give birth, I did not know where I came from. Only at the age of 23 did she decide to undergo surgery, since going to the toilet seemed like hell. The doctor suggested an operation that I was very afraid of. I felt only one shot and all.
After 15 minutes it was over. A day spent at home, after a day she began to walk with a dog, and after four went to work.2 years have passed and I'm fine.
Olga Maksimova, 25, Tuapse
She performed an operation for excision of the crack with a gentle method. Heals badly, after a toilet a pain on several hours. After the examination, the surgeon found out that I have a wound there, the origin of which is unclear.
Have made 2 times a blockade with lidocaine and diprospan with a weekly difference. They said that everything will be restored. But the pain does not pass, I feel this wound. I constantly drink vegetative laxatives, I follow a diet. How to be?
Victoria Simonova, 29, Moscow
I caught a cold on a fishing trip and began to hurt in the anus, there was blood. I went to the doctors, the proctologist said, the operation. They made laser excision, felt nothing. I spent 2 days at home and began to swarm around the house. A year has passed, I forgot to think about the problem.
Victor Ilyushin, 38, Salekhard
Than and how to treat an anal fissure, the choice makes the patient himself. And it depends on the condition of the patient, complications and course of the disease.
Doing self-medication and delaying a visit to the proctologist, the patient can only provoke complications that will be cured easily, unpleasantly and for a long time.