Prevalence and Clinical Presentation of Fissure-in-ANO in A Tertiary Care Centre
Introduction: Fissure-in-ano is a common proctologic problem encountered. It is a tear in anal mucosa distal to dentate line usually seen in the posterior midline. Hypertonia of internal anal sphincter and local ischemia is thought to be the pathology behind anal fissures.
Aim: The present study aims at determining the prevalence and clinical presentation of fissure-in-ano.
Materials and Methods: This study is a cross-sectional study conducted at Tirunelveli Government Medical College in patients with anorectal ailments who were randomly selected in this study. The diagnosis was made on the basis of anorectal examination which included inspection, digital rectal examination, and proctoscopic examination.
Results: Our study found out that out of the 325 patients with anorectal ailments, 100 patients (30.7%) were having anal fissures. Out of them, 54 were males and 46 were females, majority were under 40 years age. Pain during defecation, bleeding and constipation were reported as the common clinical symptoms. 76% of patients with fissure-in-ano had an acute presentation and the most common location was reported to be posterior midline (98%).
Conclusion: Our study reveals that fissure-in-ano is a common proctologic disease. Lifestyle modification plays a major role in cure of this condition as constipation, and low fiber diet are the direct etiological factors.
primary care. Singapore Med J 2003;44:136-40.
2. Popat A, Pandey CP, Agarwal K, Srivastava VP, Sharma SM, Dixit A.
A comparative study of role of topical diltiazem 2% organo gel and lateral
internal sphincterotomy for the management of chronic fissure in ano. Int J
Contemporary Med Res 2016;3:1363-5.
3. Suvarna R, Panchami GR. Chemical sphicterotomy versus surgical
sphicterotomy in the management of chronic fissure in ANO: A prospective,
randomized trial. J Clin Diagnostic Res 2012;6:1018-21.
4. Gupta PJ. Consumption of red-hot chili pepper increases symptoms in
patients with acute anal fissures. Ann Ital Chir 2008;79:347-51.
5. Giridhar CM, Babu P, Rao KS. A comparative study of lateral sphincterotomy
and 2% diltiazem gel local application in the treatment of chronic fissure in
ano. J Clin Diagnostic Res 2014;8:NC01.
6. Jensen SL, Lund F, Nielsen OV, Tange G. Lateral subcutaneous
sphincterotomy versus anal dilatation in the treatment of fissure in ano
in outpatients: A prospective randomised study. Br Med J (Clin Res Ed)
7. Gupta PJ. Treatment of fissure in ano-revisited. Afr Health Sci 2004;4:58-62.
8. Khan RM, Itrat M, Ansari AH, Zulkifle AS. Prevalence of fissure-inano
among the patients of anorectal complaints visiting nium hospital.
J Community Med Health Educ 2015;5:2161-711.
9. Gupta V, Rodrigues G, Prabhu R, Ravi C. Open versus closed lateral
internal anal sphincterotomy in the management of chronic anal fissures:
A prospective randomized study. Asian J Surg 2014;37:178-83.
10. Das S. A Concise Textbook of Surgery. 7th ed. Kolkata: West Bengal; 2012.
11. Sagap I, Remzi FH. Controversies in the treatment of common anal
problems. World J Gastroenterol 2006;12:3146.