Overview
An anal fissure is a small tear or crack in the lining of the anal canal, typically occurring at the posterior midline. It presents with sharp, intense pain during and after bowel movements, often accompanied by bright red rectal bleeding. Anal fissures are classified as acute (short-term, usually healing within 6 weeks with conservative treatment) or chronic (persistent tears that develop a sentinel pile and internal hypertrophy at the edges). Chronic anal fissures are associated with elevated internal anal sphincter tone and poor blood supply to the posterior anal commissure. When conservative and medical treatments fail, surgical intervention is indicated.
The Procedure
At ILS Hospitals, the standard surgical treatment for chronic anal fissure is lateral internal sphincterotomy (LIS), a procedure in which a small portion of the internal anal sphincter is divided to reduce anal pressure, improve blood flow, and allow the fissure to heal. The procedure is performed under spinal or local anaesthesia and takes approximately 15 to 20 minutes. It may be performed as a closed technique (using a blade through the skin) or an open technique (through a small incision with direct visualisation). Both approaches are highly effective, with healing rates exceeding 95%. The procedure is designed to minimise any risk to faecal continence.
Recovery
Most patients experience significant relief from pain within days of surgery. Full healing typically occurs within 4 to 8 weeks. Post-operative care includes sitz baths, a high-fibre diet, adequate hydration, and regular use of stool softeners. Most patients can resume daily activities within a week. At ILS Hospitals, our surgical team ensures thorough pre-operative assessment and precise surgical technique to deliver outstanding outcomes, relieving patients of the debilitating pain of chronic anal fissure and restoring their quality of life with minimal disruption and swift recovery.
