Rectal rupture
What is anal fissure?
An anal fissure, also known as a fissure, is a wound that runs longitudinally in the anal ring and is difficult or impossible to heal.
Hard stools or recurrent diarrhoea play an important role in its development.
Other factors may be intolerance to certain foods (especially milk) or inflammatory bowel disease unknown to the patient, or stress.
Mechanical stress can also lead to a rupture of the rectum.
This is most common in people who have anal intercourse, where sexually transmitted diseases can also cause non-healing wounds in the anus.
The increased tone and tension of the sphincter muscle is an important factor in the persistence of this condition, which is associated with severe, constant, stabbing pain and bleeding.
This causes the wound to rupture again and again with each bowel movement.
The presence of tension at work and in the private life is often observed in this disease.
The prolonged persistence of the tear can lead to narrowing, scarring, deformation and permanent damage to the anal sphincter.
An excess of tissue develops on both sides, inside and outside, of the wound that fails to exfoliate.
This prevents the wound from regenerating and healing, and often the inflammation spreads to the deeper layers.
This is called a chronic anal fissure.
Treatment of anal fissure
The aim of therapy is first to find out the cause of the crack.
In simple cases, such as food intolerance, the wound may heal in a few days if the food is not eaten.
This is a great success for the patient and the doctor.
With a 3D ultrasound scan of the head, we can also see what is holding up the wound, deep down in the tissue that is invisible on the surface, and why it is unable to peel.
Read more about ultrasound here.
In the case of chronic, non-healing rectal tears, the growths are removed on an outpatient basis.
The procedure takes a few minutes and is performed under local anaesthesia with an electric shock.
The removal does not involve bleeding.
To relieve the increased rectal tone, Botulinum toxin injections can be given from 2 directions into the sphincter to relieve the tension for three months, during which time the tear can heal.
For a very painful tear that is resistant to other therapies, we also perform an outpatient incision of the lower third of the internal sphincter.
This immediately eliminates the constant pain and the procedure takes only 3 minutes.