Abstract

Dr. Bijendra Kumar*, Dr. Suman Yadav and Dr. Ashutosh Kumar Yadav

ABSTRACT

Proctologic diseases include a diverse group of pathological disorders that generate significant discomfort to the patient. Parikartika is a common painful condition among anorectal diseases which resembles with fissure-in-ano. In the present era due to changing life style such as sedentary work pattern, increased stress, improper dietary and sleep habit, various life style disorders are increasing continuously. Anal fissure (fissure-in-ano) is a very common anorectal condition. The exact etiology of this condition is disputed, however there is a clear association with elevated internal anal sphincter pressure. Hard bowel movements are implicated in fissure etiology. The exact cause of an anal fissure is not entirely clear, but it is thought to result from trauma to the anal canal. This includes trauma to the anoderm during the passage of hard or large bowel movements, local irritation from diarrhoea, anorectal surgery, and anoreceptive intercourse. Half of all patients with fissures heal with non operative management such as high fiber diet, sitz baths, and pharmacological agents (topical/oral). When non operative management fails, surgical and parasurgical treatment will be the choice. In which lateral internal sphincterotomy has a high success rate but some complications like incontinence. In this article, we will review the symptoms, pathophysiology, and management of anal fissures.