At the exit of the large intestine, usually in the posterior midline is a painful tear-shaped wound. If If the disease has been present for a long time, the appearance of an accompanying skin tag (piece of meat) occurs immediately outside the crack.causes confusion with haemorrhoidal disease.
Why does a breech crack occur?
Constipation, hard-thick stools, diarrhoea attacks, straining too much, stressful life conditions accelerate the formation of the disease. The main mechanism of the disease is the involuntary, excessive contraction of the muscles surrounding the rectal area. This muscle contraction is the target of all elements in the treatment.
Classification
It is divided into acute and chronic anal fissure. Acute, i.e. newly developed breech crack is superficial, easily treatable. However, if there is a delay in diagnosis and it becomes chronic, treatment can sometimes be difficult.
What are the Findings?
Pain during defecation, burning and linear bleeding on toilet paper are common. In addition, pain during defecation, which is cut by glass or razor blade, is the most common description of patients. When the diagnosis is delayed, a feeling of wetness and itching are added.
How is it diagnosed?
Detailed patient assessment and palpation are sufficient for diagnosis. If there are examination findings that do not overlap with the complaints, large bowel examination tests such as rectoscopy and colonoscopy should be performed in terms of possible underlying bowel diseases.
What are the Treatment Options?
1-Vital Organisation and Medical Treatment
In the majority of patients nutrition, regulation of defecation habits, appropriate fibre supplementation, warm water shower, Treatment is possible with a combination of creams effective on regional muscle contraction.
Non-surgical treatment is recommended in cases where treatment is inadequate and surgical treatment is recommended in patients where these methods are not sufficient.
2-Botulinum Injection
Vital regulation and medical botulinum toxin is injected into the muscle in patients who do not improve with treatment Reversible muscle paralysis is provided for 4-6 months; it is aimed to heal the crack during this period.
3-Surgery (Sphincterotomy)
It is an operation that takes about 10 minutes under regional anaesthesia. A part of the muscle that is the cause of the disease is cut to allow the breech crack to heal. In the meantime, a piece of meat formed at the exit of the anus can also be removed.
Which department should be consulted for the treatment of cracks in the anus?
General Surgery Specialists perform all procedures performed due to anal fissure or anal tear (anal fissure). General Surgeons who are specially interested in this subject are called proctologists or colorectal surgeons.
Op.Dr.Gülden Ballı has seen the difficulties experienced by female patients in rectal diseases (female haemorrhoids, rectal crack) and has been working specifically on this subject for 15 years. As a female doctor, she applies treatment by taking care of your privacy in female rectal crack disease.
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22 Comments
Tuğçe Yakar
November 11, 2022Hello, I have a rectal itch that has been going on for a very long time. I have been to many doctors before and the necessary examinations have been done, but nothing is found. Itching continues to intensify. I have become unable to sleep at night. I wonder if I need to see another department?
Op. Dr. Gülden Ballı
January 11, 2023First of all, get well soon. If there is no problem with general surgery, you can contact dermatology.
Filiz Aras
October 21, 2022Hello, I have an advanced degree of rectocele. I wonder if you can help me. I would be very grateful if you give me information.
Op. Dr. Gülden Ballı
January 11, 2023First of all, get well soon, Mrs Filiz. If we have the opportunity to examine, we can give an opinion about treatment options.
Fadime Şen
May 3, 2022Hello Gülden Hanim, I am 25 years old, I have 2 haemorrhoids, one external and one internal, my pain was passing with drug treatment, but anal fissure has occurred since December. It affects my daily life quite a lot, I am doing hot water sitting, I am a little relieved, there is no medicine I have not used. I live in Kastamonu, I want to be examined by you.
Op. Dr. Gülden Ballı
May 26, 2022Hello. First of all, get well soon. During the appointment planning; if an intervention is planned, an organisation can be set up to be performed on the same day. Depending on the procedure, the time to return to normal life varies. You can contact us at 0 (546) 432 83 84 to make an appointment.
Mehmet
February 20, 2022Dear doctor, I have been suffering from haemorrhoids for 25 years and I have no significant complaints. However, for about 3 months, there is itching around the anus, wiggling as if a worm is coming out of the anus, sometimes slight burning. I am 78 years old, I do not want to enter health institutions and crowds because of this krona. I can enter if it is compulsory. I read an article on the internet that Pruzon cream is the only solution for this itching, it is not available in pharmacies, where can I find it. I am currently in Izmir / gümüldür town. I do not have a very big discomfort, but because my mind is there, I feel itchy every moment. Thank you for your attention, I would be glad if you direct me.
Op. Dr. Gülden Ballı
April 20, 2022Hello Mr Mehmet Your age and current complaints should be thoroughly assessed. Please do not use internet information to manage your treatment. Get support from a health institution as soon as possible. I wish you a healthy day
Hasan yilmaz
January 1, 2022Hello, I have two anal fissures, can there be 2 fissures due to hard discs without any disease?
Op. Dr. Gülden Ballı
January 2, 2022Hello Mr Hasan. First of all, get well soon. Fissure development caused by hard stools is common. However, unusual situations in terms of location and number should be evaluated in detail. Please be examined by a specialist physician without delay. We wish you healthy days.
Bade gül
May 5, 2021Hello, I had an adverse relationship 7 months ago. There is burning and itching in my anus. Wetness occurs when I make my large ablution. Colonoscopy was done, but no rupture was found. There is always an infection in my urine, the same in my vaginal area. There is a discharge, burning, and itching. There is no medicine I have not taken. Do you think there could be inflammation? Would it show up in colonoscopy if there is inflammation?
Op. Dr. Gülden Ballı
May 11, 2021Hello, anal fissure (anal fissure) has occurred. However, detailed examination is required. Treatment can be performed in clinical conditions without surgery. You can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon
Aygül yaşar
April 6, 2021Hello, I had 5 times abscess drainage and then fistula formed, I had fistula surgery 2 times, but now I still have pain and discharge.
Op. Dr. Gülden Ballı
April 8, 2021Hello Mrs Aygül, first of all, get well soon. Recurrent abscesses and lack of response to fistula surgery require detailed evaluation. Neglect can lead to bigger problems in the future. You should definitely set out with an experienced team. Our communication channels are open 24/7. Have a healthy day.
hasan turan
March 17, 2021Hello, one and a half years ago, I had a boil on the left hip, I went to a few doctors, the last doctor I went to diagnosed anal fistula, but did not perform surgical intervention because it was risky and said that I should go to the faculty.
Op. Dr. Gülden Ballı
March 17, 2021Hello Hasan Bey, the most important thing in rectal diseases is a good examination and the doctor's experience. Imaging methods (such as MR) are also widely used, especially in suspected anal fistula. What to do can be decided after examination and, if necessary, MRI. The majority of the treatments we apply are non-surgical methods and are performed in our clinic. If you would like to meet with us, you can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon
Serkan serkan
May 9, 2021There is a cut that will be approximately 3 months, I used lacofen madecassol, it did not pass, there is no breast formation, discharge, etc., but sometimes it hurts badly, there is only a small scratch for the treatment of bo...water or surgery is necessary?
Op. Dr. Gülden Ballı
May 11, 2021Hello Serkan bey, what you are describing may be an anal fissure (breech crack). Sometimes it can sometimes pass with appropriate drug treatment and nutritional recommendations. However, firstly, the diagnosis must be made correctly. If you want to meet with us, you can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon
Lara Us
January 23, 2021Hello, doctor, I want to come to Izmir and come to you, I have a crack in the inner and outer end of the anus. One of them has a skin protrusion mammary gland, it comes to my hand and I am visually uncomfortable. When I went to another doctor, he said that he would only take it with surgery, but I don't want surgery bo...can this mammary gland be taken together. Thank you in advance.
Op. Dr. Gülden Ballı
February 1, 2021Hello Lara Hanım, the most important thing in rectal diseases is a good examination and the doctor's experience. What to do can be decided after this examination. The majority of the treatments we apply are non-surgical methods and are performed in our clinic. If you want to meet with us, you can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon
Meric karakoc
January 13, 2021Hello good evening, I have a problem and I want to ask you. 2 months ago, I had a reverse relationship with my boyfriend and my complaints have not been going away since that day. I have been suffering from this condition for 3 months with this month, I have constant diarrhoea, burning itching in my anus, and there is a pain like a glass cut during defecation, I went to the general surgeon and explained my complaints, but he did not help, what do you think it could be?
Op. Dr. Gülden Ballı
January 14, 2021Hello, anal fissure (anal fissure) has occurred. However, detailed examination is required. The treatment is performed under clinical conditions without surgery. You can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon