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 DEFINITION
The anal fissures are longitudinal tears ó injuries in the shape of elliptical ulcers or chronic regions that appear in the mucous membrane of the year, and they are usually extremely painful.
CAUSES
The chronic constipation and the infection associated in the mucous membrane produces an ulceration in the papillae of the anal mucous membrane. The fissures are characterized by his cronicidad, with periods of aggravation and reference, often for many years.
SYMPTOMS
The described pain like heartbreaking or cutting that appears during the step of the dregs, which later disappears or weakens and is more intense again when secondary spasm of the sphincter happens.
The blood of the hemorrhage, of scarce in quantity, is of light red color, it is not mixed by the dregs, in general it is evident in the toilet paper.
A second time a constipation appears in defense of the pain that produces the defecation. During the healing there can be itch of the year.
There is usually a haemorrhoids lookout can that is observed in the exterior, and accompanies itself of spasms of the sphincters.
DIAGNOSIS
The presence of pain with the defecation, bled, constipation, spasm of sphincters, sensibility increased in the area, presence of ulcers in the mucous membrane of the year and haemorrhoids are the bases for the diagnosis of the anal fissure.
It will be possible to introduce a rectoscopio of small caliber doing pressure in the side of the anal conduit opposite to the injury, and it will be possible to see the papilla hipertrófica and the ulcer.
TREATMENT
10 indicate themselves warm seat baths ó 15 minutes after every defecation, or so frequent as it is necessary to produce mitigation of the pain.
The ointments application with anesthetic by means of an applicator for haemorrhoids placed on the end of a pipe is very useful. It is necessary to treat the constipation by means of a suitable feeding and it is possible to use local mineral oil to improve the defecation.
If with these measurements it does not improve the pain the surgical correction is proposed. The operation consists of a wide split in block of the ulcer and of the adjacent textiles.
The prognosis of the anal ulcers they tend to become chronic with alternate periods of healing and aggravation. They do not become malignant.
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