Why is this procedure done?
An anal fissure is a tear that happens in the skin around the anus. This tear can be very painful and bleed when you pass stool. Because of the pain, some people try to stop having bowel movements by not eating. ‚
The internal anal sphincter muscle controls the opening and closing of the anus. An anal fissure may have trouble healing because of the muscle movement. The doctor does an anal sphincterotomy surgery to cut a part of this muscle. This surgery weakens the muscle for a short time and gives the tissue time to heal. It may also lower pain and spasms that happen when passing stool. ‚
View OriginalView Original
What will the results be?
Your anal tear will heal and the problem will go away. ‚
What happens before the procedure?
Your doctor will take your history. Talk to the doctor about: ‚
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- If you need to stop eating or drinking before your procedure.
Your doctor will do an exam and may order: ‚
- Lab tests
- Special tests to look at the tear
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home. ‚
What happens during the procedure?
- Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- Sometimes, the doctor will give you a special drug to make you numb for the surgery. Other times, you are completely asleep.
- You may be put in one of two positions. You may be lying face down with your hips on a roll of clean towels. Otherwise, you will lie on your back with your feet in foot holders.
- The anus is cleaned with a liquid that helps prevent infection. A small cut is made in the anus. Part of the anal muscle is taken out.
- The procedure takes 20 to 30 minutes.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may go home right after the procedure. Sometimes you may have to stay in the hospital for 1 to 2 days.
- You may be numb in the anus for a time after surgery. As the numbness wears off, this area may become more painful. Your doctor will give you drugs for the pain.
- You will slowly begin to eat soft and pureed foods after surgery. Talk to your doctor about what foods are best for you.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you may take a bath or shower.
- If you need to be careful with lifting things over 10 pounds.
- When you may go back to your normal activities like work, driving, or sex.
- Be sure to wash your hands before and after touching your wound or dressing.
- Keep your rectal area clean.
- Take a sitz bath. Sit in 2 to 3 inches of warm water in the tub for 10 to 15 minutes each time. Do this 3 to 4 times a day. Carefully wipe your bottom afterwards.
- Your anus may still bleed or have a yellow discharge or fluid for a week or more after surgery. Use sanitary pads to absorb the fluid and change the pad if it gets soaked. The bleeding or discharge may increase after having a bowel movement.
- Drink 6 to 8 glasses of fluids each day.
- Talk to your doctor about how to prevent hard stools. Eat a diet high in fiber. Eat foods such as fresh fruits and vegetables and whole grains.
What follow-up care is needed?
Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits. ‚
What lifestyle changes are needed?
- Avoid sitting or standing for more than 1 hour at a time until you are healed.
- Put a pillow under your bottom when you sit to be more comfortable.
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain
- Soften stools so that they pass more easily
What problems could happen?
- Surgical site does not heal
- Tear comes back
- Large amount of bleeding from the anus
- Infection
- Problems having a bowel movement or controlling it
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine, wound that will not heal, or anal itching or pain.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Large amounts of bleeding from the anus
- Pain that is not relieved with drugs
- Problems passing stool or you cannot control your stool
- Problems passing urine
Where can I learn more?
American Society of Colon and Rectal Surgeons ‚
http://www.fascrs.org/patients/conditions/anal_fissure/ ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
Copyright
Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚