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What is an Anal Fissure?
An anal fssure is a small tear, crack, or ulcer that develops in the skin around the
lining or passage o the anus. While the tears are usually small in nature, they tend to bevery distressing and discomorting to the suerer and can be very painul as well. However,
anal fssures can be treated and mitigated accordingly.
The pain tends to worsen when you pass stool and can persist or up to two hours or
so ater the passage o eces. Anal fssures occur in both adults and children along with
people rom both sees. !n some individuals, the fssure can heal ater two weeks, but some
can take even longer. !n act, some individuals suer rom chronic anal fssures in which the
condition can last or a period o up to si weeks without notable signs o disappearing.
"auses o Anal #issures
$ome o the actors that can cause or increase the probability o suering rom anal
fssures include%
& 'ld age( older individuals tend to be susceptible to the condition primarily because o
reduced circulation resulting in decreased )ow o blood in the anal canal.
& "onstipation( stressul and painul bowel movements in the gut, especially when
passing hard stools, can cause tears in the rectal area.
& "hildbirth( childbirth can be very strenuous to the anal canal, thus causing tears and
irritation that may result in anal fssures.
& "rohn*s disease( this is a chronic in)ammatory bowel disease that aects the lining o
the digestive tract that may make layers in the rectal area more liable to tearing.
+iagnosis
Anal fssures can usually be diagnosed by assessing the signs and symptoms that appear in
the suerer. #urthermore, medical practitioners usually implement coherent methodologies
that can be used to diagnose the condition. These methodologies may include internal
sphincterotomy, colonoscopy, or a fssurectomy.
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$ymptoms o Anal #issures
. -ain( since the anal canal has an abundance o nerves, it tends to be sensitive to pain
and the patient might eperience sharp pain when passing and ater passing o stool.
#ear o more pain can cause suerers to avoid visiting the toilet, thus making them
liable to constipation.
. /lood( this usually appears as bright red spots or patches on the stool or toilet paper.
/lood is generally considered one o the prime signs o anal fssures.
0. !tching( the itching sensation can be very discomorting and can lead to urther
irritation.
Treatment
! the condition does not resolve within a ew weeks, then a doctor might prescribe
some medication to help alleviate the discomort and pain. ! the patient suers rom
constipation, a laative might also be prescribed. The patient is also advised to increase
their dietary fber intake and drink plenty o water. $ome o the prevalent treatment
methodologies include%
& $teroid creams( these are useul in relieving discomort and irritation.
& /lood pressure medications( these can help rela the anal sphincter
& 1itroglycerin( i applied as a topical treatment on the body, this will help enhance the
)ow o blood, encourage healing and also relaing the anal sphincter.
& $urgery( this is considered an advanced treatment and is used or individuals who
suer rom chronic anal fssures.
"onclusion
!t is essential or people have su2cient knowledge in the treatment and detection o
anal fssures in order to catch them early and save the patient rom a lot o pain. #or a
deeper understanding o anal fssures and their treatment options, please consult the
riendly epert colorectal surgeons at the #issure 3 #istula "enter o 4cellence in 5os
Angeles.
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Anal Fissure Treatment
Anal fissures are defined as a tear in the lining of the anus, particularly where the
feces are excreted. The tear usually extends toward a circular ring of muscle called theinternal anal sphincter. Anal fissures are considered severe when they last for less than
six weeks; they become chronic when it goes beyond six weeks. A person
experiencing an anal fissure will initially experience bleeding, tearing, ripping, or a
burning sensation after bowel movements. When a fissure develops, these symptoms
regularly occur after every bowel movement, and the rectal pain can last several
minutes to an hour. When the fissure becomes persistent, the bleeding will stop but
the pain will continue to persist. Itching and irritation of skin around the anus are also
common symptoms of an anal fissure.
Anal fissure treatment methods relieve pain and spasms experienced during the
duration of the ailment; they also aim to heal the fissure. Initial anal fissure treatments
aim to soften stool, eliminate constipation, and minimize anal sphincter spasms.
Anal fissure treatment methods
Fiber treatment is a method of treating anal fissures that bars over-distension of the anal
region. This can be done by increasing fiber in the diet, which will lead to the
softening and bulking of the stool. Regular intake of fruits and vegetables will help
because these foods are rich in fiber. It is best if you eat 20 to 35 grams per day.
Another type of treatment is Sitz baths. These involve immersing the rectal area in
warm water for about 10 to 15 minutes two or three times each day. Sitz baths can be
bought in leading drugstores; there are even portable bowls that can be used for thosewho go to work and school. This sort of anal fissure treatment improves blood flow
and relaxes the internal rectal sphincter.
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Topical nitroglycerin is an ointment applied around the anal opening two to three times
daily plus before and after bowel movements. Nitroglycerin functions as a treatment
for anal fissures by increasing the flow of blood to injured tissues. It also eases pain
and further promotes healing by lowering pressure in the internal anal sphincter.
Surgery is a treatment method that should come as your last resort when all other
methods have failed to work. Lateral internal sphincterotomy is lauded as among the
most successful surgical methods. In this method, surgeons make a small incision in
the interior of the anal sphincter. This is essential in lowering the pressure, thus easing
the pain. The fissures then cure themselves, so there is no need to close them
surgically.
Surgical methods come with minor side effects such as incontinence. However, these
side effects fade away after a short period of time. The benefits of this method far
outweigh their drawbacks.
Anal fissure treatments also include Diltiazem, Nifedipine, and Botulinum toxin.
Nevertheless, it is best if you consult your healthcare provider. He or she is always the
best source of information concerning anal fissures. No two patients are exactly alike,and recommendations may vary from one person to another; it is best that you always
seek guidance from someone who is familiar with your individual situation.
Anal Fistula: Causes, Symptoms, and Treatments
An abnormal connection of one part of the body to another is called a fistula. When
such linkage occurs in the anus it is called an anal fistula. This is a connectionbetween the interior anal canal and the skin towards the outside of the anus. There are
many kinds of anal fistulae and they may occur for a variety of reasons like infection,
abscess, pus, or other disease. They are commonly seen in patients suffering from
inflammatory bowel diseases.
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The fistula treatment recommended by a specialist will depend on the type & extent of
fistula you are suffering from. Most fistulae need surgery because they will not heal
on their own. Your fistula surgeon will recommend surgery based on the type and
severity of your fistula.
Fistulotomy is the most commonly used surgical procedure, since it is highly effective
in curing high fistulae. In this methodology, the fistula track is completely taken out
by using an advanced radio-frequency device that works under a strong light source.
Fistulotomy helps fistula to heal from the inside out. However, dressing is essential
till the entire fistula heals completely.
Regular indications of an anal fistula would be agony, delicacy, swelling, and
aggravation in the anal area. Tingling may also be experienced. The disease might
likewise bring about slight fever, tiredness, and chills. One may not have much of anappetite and may feel uncomfortable.
Anal fistulas do not normally heal on their own; medicine or surgery will be
necessary. If medicine does not work, surgery will need to be performed. Surgery for
anal fistulae in the lower end of the digestive tract is called fistulotomy.
The technique is basic. The surgeon first makes an incision at the entry point of the
fistula channel to expose then clean the infected tissue. The treated area is then
sutured closed and laid flat. If any residual bleeding occurs, an antibiotic treatment
can be applied to the area. Typically, fistulas mend quickly with little bleeding, but
proper wound care is recommended to avoid any complications.
The technique is for the most part done under local anesthesia, while the fistula is
fairly small. On the other hand, if a larger fistula has formed, it may demand a more
complex or invasive surgical procedure.
For example, when the fistula is moderately severe, a Seton may be utilized. A Seton
is a kind of suture material which is utilized to tie off the fistula. The tie holds the
fistula in place, which allows it to heal. Fibrin paste may also be utilized to seal ananal fistual. In severe cases, the Endorectal Advancement Flap technique may be
utilized. Here, a piece of the rectal divide is taken and a fold is made which is then
used to cover the interior opening. With this technique, a medical device called an
Anal Fistula Plug can be utilized. This is a funnel shaped unit made up of cutting edge
tissue which helps spur further healthy tissue growth in the fistula.
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Although anal fistulas are painful and uncomfortable, there are a variety of ways that
they can be treated. Visit your anal fistula specialist at the Fissure and Fistula Center
of Excellence to learn more.
Choosing the Best Fistulectomy in Los Angeles
For you to get the best fistulectomy services in Los Angeles, you should always
ensure you have hired the right surgeon for the services. Fistulas can lead to
experiencing a lot of social problems, pain during bowel movements, and other
discomforts. In some cases it can lead to suffering from fecal or urine incontinence.
Anal fistulas should be diagnosed and treated quickly in order to minimize discomfort
and prevent worsening of the condition. However, not all surgeons who offer
treatments will handle your case with the great care that you deserve. You should take
your time and look for the best surgeons who will address the problem the right way.
There are many surgeons available, so you should take your time and look for onewho has a good reputation for offering the best services. Here are some tips for you to
locate the best surgeon possible:
Experience
In order to get the best care, you should make sure to hire a surgeon with a good
reputation who has experience in the procedure. Check the number of years they have
been practicing as well as patient testimonials. Its also good to make sure they have
experience with patients of your particular gender and age.
Cost of the fistulectomy in Los Angeles surgery services
Choose a surgeon who charges a reasonable rate for their services, and who will work
with you so that you can afford treatment. There is no need for you to spend lot of
your money on surgeons who will exploit you. The best surgeon for you to hire should
be ready to treat you at fair rates. Often, surgeons will accept health insurance; ask if
they accept yours and if so, how much of the procedures cost you will be responsible
for. However, price should not be the main factor in choosing a surgeon.
Read reviews about the surgeons before you decide to hire them
In order to get a feel for the surgeons level of expertise and bedside manner, you
should ensure you check on what other people are saying about the surgeons. The best
surgeon whom you should hire should have good reviews in offering the best services.
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The condition of the facility where the surgeons work also matters. The best surgeon
whom you should hire should operate in a facility where they will be able to offer you
the best services. A facility that has been fully equipped with equipment that employs
the latest technology is best. You can ask other patients who have been treated for
fistulas in the facility in order to get to know more about the quality of services and
technology employed in the facility.
Anal Fissure Symptoms
An anal fissure is a small tear or cut in the skin lining the anus. Fissures are a common
condition of the anus and anal canal. They are responsible for 6 - 15% of visits to
colorectal surgeons. This condition affects men and women as well as children. Anal
fissures are usually not a cause for undue concern, as most heal without any medical
treatment. Unfortunately, they do not always heal on their own, and in some cases are
severe enough to resist conservative treatments as well. In such cases, it is necessary
to seek the help of an expert colorectal surgeon. The following are anal fissure
symptoms:
Pain In The Anal Area
This is a common fissure symptom. This pain can sometimes be severe, especially
during bowel movements. This severe pain is usually caused by inflammation of the
anus and rectum. In certain cases the pain is so excruciating that it makes defecating a
problem. The worst part of all this is that this pain can last up to several hours.
Sentinel Pile
This is a tag of skin that may develop on the edge of the anus below the fissure. This
tag develops when the fissure is ignored or not treated quickly enough. This pile not
only makes it hard for you to pass stool but it also makes it difficult to wipe the anus
after visiting the toilet.
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Streaks of Blood On Stool Or On Tissue Paper After Wiping
After having a bowel movement, you may notice a streak of blood on the toilet paper
or on the stool. When the bowel passes on the torn area, it bruises the area and as such
blood from the wound is smeared on the stool. This causes a lot of pain and can be
very uncomfortable.
Burning Or Itching In The Anal Area
Sometimes, the patient may experience some itchiness around the anal area. This
might be mistaken for a reaction to a pinworm infection. However, this itchiness can
be very embarrassing, especially if it happens in a public place. Therefore, it is very
important to seek help from a professional as soon as possible.
A Visible Crack In The Skin Around The Anus
In extreme conditions, there may be a visible crack in the skin around the anus. This is
very dangerous, since stool passes through this area. This means that, it will take time
to heal because of the stool and the constant wiping of the area.
Causes Of Anal Fissures
Anal fissures can be caused by the following:
Chronic constipation
Diarrhea
Passing dry or hard stool
Inflammation of the rectum or the anus
Pregnancy
Scratching around the anus
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Crohns disease
Anal injury
Cancer of the rectum
Childbirth
To conclude, although there are several treatment options for anal fissures, it is
important to seek medical attention from a professional. Therefore, in case you
experience any of the above anal fissure symptoms, or you want to learn more about
anal fissures, please visit www.fissuresurgerymd.com for treatment options, advice
and specialized care on anal fissures. Alternatively, contact the expert colorectal
surgeons at the Fissure & Fistula Center of Excellence in Los Angeles.
What are the Proven Surgical Treatments for Anal Fistulas?
The anus is the external opening through which feces from the body are driven out.
There are a number of small glands just within the anus. If any of these glands is
blocked, this can be an abscess - an infected cavity. An anal abscess is usually treated
by surgical drainage, although some are spontaneously drained. Around 50% of
abscesses can become fistulas, in which a small tunnel connects the infected glandwith an opening in the skin around the anus, usually within one year.
Treatments for Anal Fistulas
Anal fistulas are often treated with a surgical operation done by a colon and rectum
specialist. During the surgery, the doctor will assess the depth and breadth of the
fistula tract. Most fistulas are treated using a fistulotomy, in which the skin and the
muscle above the tunnel are cut, turning it into an open groove. This will allow the
fistula tract to heal from the inside out. A more complex fistula may require a special
drainage device - a seton - for at least six weeks, after which a definitive surgical
repair is done. For fistula surgery done on an outpatient basis, the tunnels of a fistula
that are very large or deep may need a short stay at the hospital.
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What are the Surgical Treatments for Anal Fistulas?
These surgical treatments are intended to definitively eliminate the fistula and correct
abnormalities that have emerged as a result of the same, without compromising anal
continence. The disappearance of the fistula implies the disappearance of the
associated painful discomfort, inflammation or/and oozing.
Depending on the type of fistula, its path, depth, etc., different types of intervention
can be made.
Fistulotomy:
This procedure consists of the opening and emptying of the fistulas as well as
ensuring healing as efficiently and quickly as possible.
Fistulectomy:
This procedure involves complete excision of the fistula. The disadvantage with
respect to the fistulotomy technique is that it leads to larger wounds and, therefore,
healing is slow and expensive.
Line or seton:
There are three variants of this technique, depending on the overall objective of the
surgery.
Cutting Seton: the goal of this mode is the elimination of the fistula. This is done
through the same surgical silk that is tightened gradually for the silk section in the
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sphincter but at the same time have enough time to heal.
Drainage Seton: This is carried out to drain the pus or detritus of the fistula, which
will prevent the formation of a new abscess. Silk will be placed through the fistula,
and once completed, the process of drainage allows surgical repair in the absence of
infection.
Seton Guide: This is placed in the same way as the drainage seton. Its function is to
keep the fistula permeable until the patient can be operated on permanently.
If you suspect yourself to have a fistula, there can be no better place to get the needed
diagnosis than from professional doctors specialized in anal fissures. Why don't youvisit Los Angeles colorectal expert surgeons at the Fissure and Fistula Center of
Excellence, known for their intensive care on conditions affecting the anal area and
rectum, including anal fistulas?
Anal fissure surgery in Los Angeles - The Basics
The initial treatment for anal fissures begins with topical and oral medications. It is
only when these medications fail to work that fissure surgery comes into place. The
basic treatments involve the use of calcium channel blockers and glyceryl trinitrate
that is suggested by a healthcare provider. Sometimes, even mild laxatives are
suggested to make stool soft and decrease straining and pressure.
Before going for anal fissure surgery, you should read some articles on fissure surgery
methodology to verify that you have satisfactory information. Fissure surgery is the
final resort for treatment, and should only be considered when more conservative
treatments fail to work.
Preparing for a fissure surgery in Los Angeles
Your surgeon will explain the fissure surgery process as well as any special steps orrequirements to be met beforehand. There are certain restrictions to be followed
before surgery; for example, you can't smoke. Smoking increases the danger of
developing infection in the midsection, which will slow recuperation post surgery.
Therefore, it is essential to control certain variables.
Prior to the operation, you have to have a totally solid discharge. So as to accomplish
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this, you may be given a specific diet to follow for two or three days, and purgatives
too before the day of surgery.
Fissure surgery in Los Angeles is performed in a single day. Once the surgery is done,
you can go right home, although you will need to follow post-surgery guidelines.
The Procedure
The surgery can be done under general anesthesia, so you will be sleeping during the
surgery. However, local anesthesia can often be used instead. Local anesthesia numbs
the area to be treated so that you will not feel any pain or discomfort, but will still be
awake. The benefit of local anesthesia is that recovery time is quicker immediately
following the procedure, and you can avoid potential side effects of general
anesthesia.
Your doctor will determine which type of anesthesia is best based on your individual
condition and constitution.
The surgery for anal fissures is known as anus sphincterotomy, which involves
making a cut in the anus sphincter muscles. This will allow you to strain less than
normal when you go to the restroom, and this in turn will put less pressure on the
fissures, accordingly giving you more opportunity to recuperate.
The incision is made into the sphincter muscles using a razor sharp edge. At thatpoint, a dressing cushion is placed into the anus in order to stop any bleeding.
Post Surgery
Post fissure surgery, it takes almost no time to recuperate. Then again, you may need
to rest for quite a while until the analgesic state has passed. You may need pain
relievers as well. Most patients are free to leave soon after the surgery; however, some
may need to stay overnight.
Botox for Anal Fissures - Treat Fissures Without Causing Harm
An anal fissure is a tear in the skin around the opening of the anus (the last part of the
digestive tract that controls the removal of stool). An anal fissure is associated with
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pain and bleeding during bowel movements. The condition is more common in young
infants but it can happen at any age. Anal fissures are usually caused by trauma or
injury to the anal canal while passing hard or large stools, constipation, diarrhea or
childbirth.
The average symptoms of an anal fissure include pain during and a few hours after
solid discharge. Despite the fact that the tear created by an anal fissure is small
(around 1cm), the condition is painful and may endure for an hour or more in the
wake of defecation. The extreme pain may make patients worried to the point of
avoiding defecating, which further exacerbates the condition. Pain is normally more
intense in more severe anal fissures. Different side effects include:
Blood in stool, on toilet paper, or in the toilet bowl
Broken or torn anal skin
Bothersome fissures
Yellow release that has an offensive smell
Chronic anal fissures can become deeper and form ulcers, which can further slow the
healing process.
Most anal fissures can be analyzed by a physical examination which involves viewingthe anal area and reviewing your therapeutic history. At times, diagnosis is finished by
a computerized rectal examination or by using an instrument called an anoscope. The
anoscope is a short instrument with a lit tube which can help the specialist see and
examine the fissure.
Anal fissures normally heal on their own in a couple of days or weeks (acute),
however, in situations where it doesn't mend even following 6 weeks (chronic),
restorative treatment or surgery is suggested.
Botox for anal fissures more often than not involves adopting straightforward
measures to keep your stool manageable; for example, by increasing fiber and liquid
intake. Soaking in warm water for 10 - 20 minutes as frequently as possible,
especially after defecation, additionally assists with healing and reducing discomfort.
In the event that symptoms still continue, further treatment may be necessary, which
involves using steroid creams and Botox injections. Topical soporifics and pain
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solutions might likewise be recommended to control pain.
Surgery is prescribed if symptoms don't react to conservative treatments. Surgical
treatments include:
Horizontal internal sphincterotomy
Fissurectomy, which involves surgically removing the anal fissure and leaving an
open injury to recuperate
Anal grafts, which involve replacing broken tissue with solid tissue from elsewhere
on the body
Horizontal sphincterotomy is the most widely recognized surgical method indicated
for the treatment of anal fissures. The surgery is typically performed under localanesthesia in an outpatient setting, where you can go home the same day as the
surgery. The surgery involves making a small cut or incision in the sphincter muscle
to decrease the strain in your anal canal, which permits the anal fissure to recuperate.
The incision can be closed or left open to recuperate.
After the surgery you will be given some painkillers. Remember to remove the
dressing before any solid waste discharge. Complete recuperation from anal fissure
surgery may take a while; however, this changes between individuals.
Likewise, as with any surgery, anal fissure surgery involves certain risks, for example,
danger of infection and anal incontinence, which includes the inability to control gas
and loss of strong stool.
Anal Fissures: Lateral Internal Sphincterotomy
Surgery may be needed if medicine fails to heal a tear (fissure) in the anus. The
preferred procedure is lateral internal sphincterectomy. A doctor makes a small
incision in the internal anal sphincter, one of two muscles that control the anus. This
can be done as outpatient surgery under local anesthesia or general anesthesia. Theinternal anal sphincter is constantly under strain, otherwise called resting weight. On
the off chance that that weight turns out to be too high, a fissure may form or an
existing one may not heal on its own. An incision diminishes the resting weight,
allowing the fissure to mend.
It's imperative to understand that, even with surgery, an anal fissure must mend all
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alone. A sphincterotomy involves operating on the sphincter muscles, not closing the
actual fissure.
Lateral internal sphincterectomy has a superior success rate than any medicine that is
utilized to treat chronic anal fissures. The outcomes last longer, and fewer individuals
have recurrent anal fissures than after treatment with medicine alone.
An anal fissure can bring about a considerable measure of pain, regularly resulting in
stoppage as patients become hesitant to pass stool. Bleeding is commonly seen on
bathroom tissue after defecation, and the blood is deep red. Numerous anal fissures
are thought to be brought about by passing hard stool, and frequently they will heal
independent from outside treatment. In individuals where the fissure does not heal on
its own, it is believed that an anomaly of the internal anal sphincter may be available,
which decreases the measure of blood flowing to the fissure. The sphincter muscle
weight is regularly too high, and lateral internal sphincterectomy can bring down theweight to an ordinary level.
For most patients, restorative anal fissure treatment is effective by using measures
such as stool softener and high-fiber diets. It is when such medications come up short
that patients may experience a lateral internal sphincterotomy methodology. Surgery
can be done under general anesthesia, where the patient is fully unconscious, or local
anesthesia, where the area treated is numbed but the patient is still conscious.
The specialist utilizes a surgical tool to make a cut in the round internal anal sphinctermuscle. It is critical not to harm the outside anal sphincter muscle which encompasses
it. The surgery takes around 15 minutes to perform and patients can ordinarily return
home that day. A great many people make a full recuperation and find that their anal
fissure pain diminishes rapidly.
Lateral internal sphincterectomy difficulties are uncommon. However, some risks
may include infection, pain and bleeding. Now and then patients are left with a level
of incontinence, which may involve passing defecation together with gas, or a small
measure of involuntary soiling. Most often, these issues come up immediately after
surgery but resolve later. In some patients, the anal fissure does not mend following
lateral internal sphincterotomy, or the fissure repeats. Around half of situations where
the fissure does not heal completely are connected with an inflammatory condition
known as Crohn's disease.
In the event that you are deciding whether to have this surgery, it is critical that you
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consider the possibility of incontinence. In some cases, the danger of incontinence is
high enough that lateral internal sphincterotomy should not be considered. This may
be the case for women who develop an anal fissure during childbirth, in light of the
fact that they regularly don't have a high resting weight in their internal sphincter. A
methodology called anal progression fold may be done instead of sphincterotomy. In
this system, the edges of the fissure are evacuated, and sound tissue is sewn over the
zone.
What is a Fistulotomy? - Fistulotomy in Los Angeles Explained
A fistula is an abnormal connection or passageway formed between the end of the
bowel and the skin near the anus. An anal fistula is the channel formed between the
anus and perianal skin, causing bleeding and discharge while passing stool as well as
pain. Fistulas can either develop spontaneously or secondarily to perianal or perirectal
abscess drainage after a surgery. A fistula has two openings an internal opening inthe rectum or anus and an eternal opening in the buttocks.
Fistulotomy in Los Angeles Overview
An anal fistula can be an abnormal channel as well as tunnel-like lesion that starts in
the anus and ends outside around the skin of your hindquarters. Its development is
usually the result of a previous anal infection or abscess. About 50 percent of men and
women with an anal abscess have a fistula.
Diagnosis of Anal Fistula
Usually, a simple clinical evaluation is sufficient to diagnose the occurrence of a
fistula, which involves a proctoscopy. However, in some cases, a fistula doctor may
suggest an MRI Fistulogram.
Fistula Treatment
Surgery is probably the main treatment alternative to cure an anal fistula. Antibiotic
medication can certainly control the infection, yet the key danger of recurrence always
persists. In some cases of fistulas, persistent drainage is observed, whereas in other
cases, the outside opening of the channel closes and the major danger is a recurrent
abscess. The type of surgery depends on the size and location of the fistula.
DISADVANTAGES
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Pain-This surgery leads to a large channel from the anal opening to the cheek.
Understandably this leaves the patient with some pain in the post operative period.
Invasive-The procedure involves incisions which may scar.
Long Hospitalization-The patient generally needs hospitalization for 4-8 days or even
longer.
Long recovery time - The patient requires dressings for 4-6 weeks and should not go
to work during this time.
High recurrence rates-. In spite of all these difficulties, this surgery is associated with
a high recurrence rate.
Danger of Incontinence-The procedure has a definite danger of incontinence,
especially in high fistulas.
Surgical Treatment of Fistula
Fistulotomy
Recent statistics demonstrate that 85-95% of fistula patients undergo fistulotomy.
In this procedure, a small divide of the anal sphincter is sliced in order to open the
fistula tunnel.The inner contents of fistula are flushed out, which heals after a month
or two and resembles a flattened scar.
Surgery for anorectal fistulae is well on the way to cause certain side effects, for
example, recurrence, infection, and incontinence; however, some patients may not
experience any side effects. The most important thing to note in case of fistula
treatment is that one ought to never go further without proper diagnosis, professional
expertise, and authentic treatment.
A great deal of research is going on worldwide to discover more treatment alternatives
for fistulas which can be less painful, less expensive, and with fewer side effects.
There are two kinds of surgery which are the oldest and the best studied of all the
methods. In a fistulotomy, the fistula tract is laid open by cutting out the whole tract
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with knife. In a fistulectomy, the fistula tract is totally taken out. The resultant injury
is generally not closed and left open to heal on its own. Along these lines the chances
of recurrence are decreased.
Following a fistulotomy in Los Angeles, topical antibiotics in addition to dressings are
used to prevent bleeding and infection. The patient is conveyed to a recovery room till
the anesthesia wears away. They are then usually prescribed antibiotics in addition to
painkillers and presented with instructions about tending to surgical injuries at home.
Some discomfort with sitting and bowel movements may occur for around a month of
recovery. A follow-up appointment with your doctor can affirm the process was
successful and that healing is taking place.
Are there Any Topical Treatments for Anal Fissures?
A lot of different factors can lead to the development of fissures in the anal liningamong men and women of all walks of life. Although not considered serious initially,
the condition may worsen when not treated at the earliest possible time. Anal fissures
brought about by pregnancy and other acute causes are not necessarily treated with
surgery, but if you are experiencing severe symptoms such as painful bowel
movements that last for hours or frequent appearance of blood in your stool, surgical
intervention by colorectal surgeons at the Fissure & Fistula Center of Excellence in
Los Angeles may be required.
Topical Treatment for Anal Fissures
In mild cases of anal fissures, non-surgical treatments are often indicated. Topical
treatment for anal fissures is primarily aimed at not only promoting the healing
process but also at relieving physical symptoms. To avail yourself of the best topical
treatment specific to your case, consulting a colorectal surgeon in Los Angeles is a
very good decision.
Both acute and chronic anal fissures are treated with topical treatments. Some of themost common topical treatment options include the following:
1. Calcium channel blockers
Calcium channel blockers help relieve symptoms and promote healing in cases of anal
fissures by reducing pressure in the area. Although associated with certain side
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effects, these medications, when used according to your doctors instructions, are
generally safe and effective. Calcium channel blockers come in gel form. The
medication is applied in the area four times a day or as prescribed by your physician.
2. Nitroglycerine cream
Nitroglycerine cream is another medication usually prescribed for healing chronic
anal fissures. With its many side effects, however, application of the cream in the
fissures must be made with utmost care. Nitroglycerine works by reducing pressure in
the anal sphincter muscle.
How Botox Helps Treat the Condition
In cases unresponsive to topical treatments, colorectal surgeons in Los Angeles
usually recommend Botox treatment. Though commonly known as a cosmetic surgery
procedure, Botox has become a breakthrough treatment for anal fissures over the
years. Botox helps promote healing of anal fissures by paralyzing the anal sphincter
muscle, thus promoting relaxation.
The treatment is usually conducted within the clinic and lasts for a few minutes to
hours. Most patients are usually allowed to go home immediately after a Botox
injection.
Treatment Considerations
It is very important for you to finish the topical treatment regimen to complete the
healing. Some patients stop treatment after symptoms begin to cease, but completing
the treatment is essential to prevent relapse of symptoms. A follow-up appointment
after the treatment is also necessary to determine whether you are completely healed
or if you need further medication.
Other important tips for faster treatment include the following:
-Avoid straining bowel movements.
-Increase fiber intake.
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-Increase oral fluid intake.
-Exercise regularly to promote peristalsis.
Conclusion
Anal fissures are non-serious conditions that can bring about painful or uncomfortable
symptoms. To know more about anal fissures, its causes, symptoms and treatments,
contact your trusted colorectal surgeons at the Fissure & Fistula Center of Excellence
in Los Angeles or visit their official website at www.fissuresurgerymd.com.
All you need to know about fistula surgery in Los Angeles
A fistula is a disease which people think cannot be cured fully or involves a lot of
pain. To come out of this misconception we first need to understand what a fistula is,
how it occurs, and what its symptoms are. A fistula is an abnormal passage between a
hollow or tubular organ and the bodys surface, or between two hollow or tubular
organs. There are two types of fistula: one is called a high fistula & the other is a lowfistula. There are many causes which can lead to a fistula, such as those as follows:
1) Infection at anorectal abscess
2) Pus discharge
3) Unhygienic state of anal region
4) Trauma near anal region
5) Constipation
The symptoms of a fistula can include:
1) Discharge
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2) Pain at anal region
3) Boils near anal region
4) Recurring injury at anal region
5) Fever & chills
More often than not the skin appears red and inflamed in the area from which the
discharge and blood comes. Finding the fistula opening in the anus is very important
for treatment of fistula surgery in Los Angeles. A fistula diagnosis can be done by a
proctoscopy or MRI fistulogram. A fistula doctor then decides the course of treatment
once the reports have come. There are many treatments available for fistulas,
depending upon the severity. Some of the treatments for fistulas are as follows:
1. VAAFT-Also known as Video Assisted Anal Fistula Treatment. This is an
innovative technology for selected fistula cases.
2. Ksharsutra-This is a traditional ayurvedic therapy.
3. Fistulectomy-The fistula tract is completely removed using an advanced
radiofrequency device under a special light source.
4. FiLAC-This is Fistula Laser Closure. It's a procedure performed with the help ofthe Leonardo Laser Device that gently and effectively cures the anal fistula and also
prevents damage to the sphincter.
The surgery to take care of a fistula is conducted under local anesthesia and takes
around thirty minutes unless there are other complications. The most essential danger
involved could be the elasticity of the sphincter muscles inside the anus. These
sphincter muscles would be the tissues that assist in contractions as well as relaxation
throughout the anus so that bowel movement may be possible. Once the tract is
identified, the surgeons for VAAFT treatment ensure that the complete tract is
cleansed and then the opening is closed. The tracts are left open so that secretions in
the post operative stage can easily find a way out. The doctors then monitor the
patient and check the progress. In the vast majority of the cases of open fistula
surgery, the tracts do not heal as the tissues have the tendency to form a collagen layer
over them that hinders healing process. However, through the VAAFT technique there
is no such problem, as there is less chance of infection through a large incision; rather
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a scope is used and the puncture is quite small. This also improves the healing time.
Along with aforementioned benefits, when this process is conducted by the best
VAAFT surgeon then the operative time reduces by more than half.
Following the fistula surgery in Los Angeles, recurrence of the anal fistula may be
possible. Slight bleeding, pain and uneasiness may be experienced not long after this
process until there is complete recovery, which can take a month. Not long after the
process, a normal eating plan as well as other activities can be carried out.
The Best Treatment for Anal Fissure in Los Angeles
Anal fissure is a common problem found amongst all ages and all sexes. It is basically
a disease caused by constipation. It is a cut or the tear in the lining of the anal canalwhich causes severe pain while defecating. It normally lasts for 6 weeks or less;
however, if it continues for longer than that, it is considered chronic and is a more
severe problem.
At times along with the pain the patient even starts bleeding. Then the situation
becomes very dangerous, which should not be ignored. Immediate treatment for this is
always advisable.
Many patients have been successfully treated for anal fissures in Los Angeles at the
Fissure and Fistula Center of Excellence.
What Causes Anal Fissures?
Anal fissure is mainly caused due to the following reasons:-
1) When an excessively large stool is passed.
2) When there is extreme pressure on the anus when passing bowel movements
3) With repeated diarrhea
Anal fissures are also common for women after childbirth. There could be some other
minor reasons as well like anal intercourse, rectal exams, or application of any foreign
object in the anus. At times they can be caused by Crohns Disease.
Major Symptoms Of Anal Fissures
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Acute pains in the anus during bowel movements associated with rectum bleeding are
the two main signs of this disease. And if the pain is too severe then it produces a
burning sensation for more than 2-3 hours.
What Could Restrict The Occurrence Of Anal Fissures
Anal Fissures mainly occur due to constipation, so if this is cured then the chance of
getting this particular disease is minimized. For that, more fibers should be taken in
the diet along with sufficient fluids. Also some stretching exercises could be very
helpful. All these should be done to regularize the bowel movement.
Treatment of Anal Fissures
Fissure treatment in Los Angeles- As mentioned above, the treatment of this disease
has been quite successful in Los Angeles, specifically in the La Peer Fissure & FistulaCenter of Excellence. Here the patient is treated in both surgical and non surgical
ways. The best treatment plan for the individual patient is decided based on a number
of factors, including the severity of the fissure. For example, if the doctor feels that
the cut is minor, then normal non surgical treatment is initially applied, such as a Sitz
bath, zinc oxide cream, etc. However, if it is found that the wound is too deep, then
the doctor may recommend surgery.
The technology used for this treatment is the latest and most advanced, and moreover,
special attention is given to heal the torn area as soon as possible. The facilities and
the medicines offered here are state of the art.
In fact, a recent innovative therapy has been introduced here which cures acute Anal
Fissures immediately. This treatment is Botox injections. These injections are applied
directly into the internal anal sphincter area. It is an effective and quick healing
procedure which does not require anesthesia.
To know more about the anal fissures and their treatment options, please refer to the
expert colorectal surgeons at the Fissure & Fistula Center of Excellence in Los
Angeles. Or you can visit their website at www.fissuresurgerymd.com
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Anal Fistulae An Overview
Over 200,000 people in the USA are diagnosed with anal fistula every year, making itone of the most commonly prevalent anorectal conditions. An anal fistula is an
abnormal, inflammatory passage that gets formed between the anal canal and the skin
adjacent to the anus.
Fistulae are caused due to the presence of an abscess in the anorectal area. When an
anal gland becomes infected, it can lead to development of an abscess. The abscess
may stay confined to the area of infection or may spread down to the perianal region,
resulting in the formation of a fistula. Almost 50% of the people who get anal fistula
go into developing chronic fistula that lasts for several weeks.
Anal Fistula Symptoms
An anal fistula is a painful condition that is characterized by throbbing, which
worsens when the patient sits down. The patient experiences swelling, scarring, and
redness of skin adjoining the anal orifice. Other symptoms include a discharge of
blood and abscess while passing stool. Constipation and pain associated with
difficulty in bowel movements are common indicators. The patient could possibly
develop a high fever, and should seek medical attention if it goes beyond 38 C
(100.4F). Since the body is unable to get rid of toxins as efficiently as it should, the
patient is bound to feel nauseous and constipated.
The diagnosis of anal fistulae is fairly simple. A digital rectal exam usually suffices to
identify an anal fistula. Digital exam refers to the process wherein the doctor inserts
their gloved finger into the rectum to detect any abnormalities on the walls of the
rectum. This is done with the help of a lubricant to minimize the discomfort for the
patient. In some cases, the colorectal specialist may need to conduct a thorough
clinical evaluation, consisting of ultrasound, MRI or CT scans. This is usually done to
diagnose associated conditions like rectal cancer, inflammatory bowel disease and
sexually transmitted infections.
Treatment for Fistulas in Los Angeles
There are 3 treatment plans available, depending on the type of fistula and the extent
of damage that it may have caused. Filling up the fistula with fibrin glue is a non-
surgical procedure. Though the initial success rate of 77% looks promising, it drops to
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14% after sixteen months. Up until now, surgery has been the only reliable technique
to repair the fistula.
The third treatment plan involves filling the fistula cavity with a bioprosthetic plug
and securing it with stitches to keep it in place. The bioprosthetic plug is also known
as fistula plug, in simple terms. The method promises a success rate of 80%. A team
of colorectal specialists in Los Angeles have been working on it to perfect the method
and help the patients of anal fistula. The fistula plug is a conical plug that is made
from human tissue, and uses the submucosa of the small intestine. Since the fistula
plug is a made from something as natural as a human tissue, it merges completely
with the patients tissue at the end of the healing process.
The fistula plug is a better option than full-blown fistula surgery and fibrin glue.
However, the procedure has its own risks. To discuss your prospects with this
treatment plan and the possible risks, you can get in touch with the colorectalsurgeons at the Fissure & Fistula Center of Excellence in Los Angeles.
To learn more, please visit www.fissuresurgerymd.com.
How is the LIFT Procedure Performed?
Anal fistulas do not have a specific cause, but there are ways to live a healthy life and
minimize risk of developing the condition. A patient with an anal fistula often sufferspain along with discomfort. If an anal fistula recurs or becomes chronic, it may
require surgery. In this unnatural condition, channels or connections are formed in
between the organ of body plus the anal region. Human body fluids and pus might
leave the body because of this anomaly.
An abnormal network of one section of the body to another is known as a fistula. In
the point when such linkage happens inside the anus it is known as an anal fistula.
This is a connection between the inside anal canal and the skin towards the outside the
anus. There are many varieties of anal fistulae, and they may happen for manydifferent reasons such as contaminants, abscess, discharge, or different diseases. They
are often found in patients suffering from inflammatory bowel diseases.
Basic symptoms of an anal fistula can be pain, delicacy, puffiness, and irritation inside
the anal area. Tingling is often experienced. The contamination can also cause slight
fever, tiredness, chills, as well as weakness. Patients may not have an appetite, and
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will feel discomfort.
The Actual Technique
LIFT, which stands for ligation of intersphincteric fistula tract,is a minimally invasivesurgical procedure which does not require the sphincter muscles to be cut. This procedure
involves securely closing the internal opening of the fistula and removing infected
cryptoglandular tissue. .
This LIFT procedure starts off by making an incision in the fistula opening in the anal
canal to find where it is in the intersphincteric tract, the spot involving the sphincter
muscle groups. Another incision is made in the external opening of the fistula, and a
tube is placed through the fistula in order to identify the tract and clean the area.
Infected tissue is removed. Then, both openings are closed in order to prevent both
infection and recurrence of the fistula.
A seton can also be used to widen the fistula to facilitate removal of infected tissue. A
few weeks later, your doctor will remove said infected tissue and close off the fistula
openings, which allows them to collapse and heal.
The system is normally carried out under local anesthesia, if the fistula is not too
large. However, sometimes fistulas may require more complex surgery in which
general anesthesia may be needed.
A seton may be necessary in the case of abnormally large fistulas. A Seton is a type of
suture material that is utilized to wrap the abnormal pathway. A circle can be formed
which prevents movement, which aids in healing. Alternatively, fibrin paste can be
utilized to create coagulation inside the tract to close it off. In a complicated
condition, the Endorectal Improvement Flap system could possibly be utilized. Here,
part of the rectal wall is analyzed and a flap is created to cover the interior opening.
With this system, a medical item known as an Anal Fistula Plug may be used. This is
a conical unit made up of advanced tissue graft which often advances tissue
development inside the affected area.
To learn more, please visit www.fissuresurgerymd.com.