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Suffering from Cronic Fissure
Patient History & Symptoms (Student):
History: Final-year student suffering for 6 years from a chronic anal fissure/pain condition.
Surgeries: Had an injection (3 years ago), laser surgery (3 years ago), and Ksharsutra (2 years ago). All failed.
Current Pain: Persistent, sharp pain in the exact same spot (half a finger deep) inside the anus.
Bowel Pattern: Incomplete emptying. First pass clears 70-80%. The rest only clears after eating later, or by holding the bowel until severe, natural internal rectal pressure builds up to clear it automatically: Ready for hospitalization/extended treatment if required to resolve this permanently. Please provide contact number so I can call you I do not have much money to contact directly on practo apointment video call.Please consider request.
Answers (13)
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Six years of chronic anal fissure with three failed procedures including laser surgery and Ksharsutra is a complex case that needs a completely different approach before any further intervention. The persistent same-spot pain and incomplete bowel emptying strongly suggest ongoing internal sphincter dysfunction that has not been addressed properly in previous treatments.
Next Steps
A proctological evaluation with anorectal manometry would be the right next step to assess sphincter function before deciding on the best permanent treatment option. Feel free to consult me directly on Practo for a detailed evaluation â I can guide you toward the right path forward.
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As symptoms are persisting despite previous procedures, a detailed evaluation by a colorectal surgeon/proctologist is recommended.
Persistent pain and incomplete evacuation may indicate an underlying fissure, sphincter spasm, pelvic floor dysfunction, or another anorectal condition requiring further assessment.
Feel free to book a consultation so we can discuss the complete treatment plan in detail
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Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
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Detail answered by dr anuska
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Hello , thank you for the question.
I understand how incredibly frustrating and painful it is to deal with a condition that has not resolved despite multiple surgeries.
When treatments like laser surgery and Ksharsutra do not fully resolve a fissure, it usually means the underlying cause such as severe muscle spasm or a coordination issue in the pelvic muscles , has not been fully corrected. The incomplete bowel emptying you described strongly suggests that your pelvic floor muscles may be tightening instead of relaxing when you pass stool. This constant straining prevents the area from ever truly healing.
I completely understand that you are going through an incredibly difficult, painful, and financially straining situation. However, please note that it is not possible to share personal contact or phone numbers on a public medical platform like this due to strict privacy and professional regulations.
Before trying any more procedures, it is highly recommended to undergo an Anorectal Manometry and an Endoanal Ultrasound or a defecography even .
Furthermore, because you have already undergone multiple surgeries and are still experiencing complex symptoms l, a virtual consultation will not be sufficient to resolve your condition. Online consultations cannot replace the physical examinations, pressure monitoring , and specialized imaging required to find out exactly why your previous treatments failed.
To help manage costs while getting the expert care you need, I highly suggest visiting the colorectal or gastroenterology department of a government medical college hospital or a subsidized public hospital in your area, where these advanced diagnostic tests and specialized treatments can be accessed at a highly nominal fee.
Next Steps
For now you can try these treatments till you reach out to a gastrosurgeon
Warm Sitz Baths 2 to 3 times a day, particularly right after a bowel movement, for 10 to 15 minutes each time.Do NOT use hot water. You can add 3-5 ml of betadine 10% w/v solution.
Apply a small, pea-sized amount of Lignocaine 2% Jelly gently around the anal opening and just slightly inside the edge.Apply this about 10 to 15 minutes before you expect to have a bowel movement. This will help numb the area so passing stool is less painful. You can also apply a tiny amount after your warm sitz bath if needed. WASH HANDS before and after application.
Gentle soluble fiber (like Isabgol) any company of your choice ( like softolax) 2 spoonfull taken with a full glass of water at night .Consume at least 2.5 to 3 liters of water daily. Soluble fiber without adequate water will actually turn stool into a hard mass, worsening the incomplete emptying.
Never sit on the toilet for more than 5 to 7 minutes trying to force stool passage .Natural squatting position allows stool to pass with significantly less resistance and straining.
Health Tips
When applying Lignocaine jelly, refrain from inserting your finger or the applicator deeply into the anal canal to reach the fissure site.
These medications may mask symptoms, so it is crucial to monitor for active, continuous bleeding or foul-smelling purulent discharge.
It is imperative (MUST) to consult a gastrosurgeon, colorectal surgeon, or proctologist as soon as possible, as these measures are temporary and not a cure; they merely provide symptomatic relief until you can see a specialist.
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Needs local examination and management
Consult a General surgeon for Surgical management
Next Steps
Untill then ,
Lignocaine 2% gel L/A. 2 times a day
Diltiazem or Nifidepine ointment L/A. 2 times a day
Sitz bath with 10 ml of povidine in it.
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Hi, you can achieve lasting relief with proper care. 😊
The incomplete emptying and sharp pain suggest spasm or scar tissue common in long term cases.
Feel free to consult for further guidance. 👍
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You r to consult some good local Surgeon
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Take cremaffin 10ml during night
Drink plenty of water
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Khemaram Godara
General Physician
1 yrs exp
Barmer
Consultant with Colorectal surgeon / GI surgeon
Next Steps
MRI PELVIS FISTULA PROTOCOL
Health Tips
use sitz bath
lignocaine gel for pain
lectulose for constipation
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Dr. Sachin Bhiwaji Sanap
General Practitioner
7 yrs exp
Hingoli
Consult to any general surgeon it’s needs to be evaluated properly
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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