Dr. Kamal Gupta

What is an Anal Fissure?

An anal fissure is a small tear or cut in the lining of the anal canal, usually extending from the edge of the anus up to a small area called the dentate line. This tear can cause severe pain, especially during and after bowel movements, and sometimes bleeding. Most fissures occur at the back (posterior) or front (anterior) midline of the anus. Anal fissures are cracks or tears in the anus and anal canal. They may be acute or chronic.

Causes Of Anal Fissure

Anal fissures are caused primarily by trauma, but several non-traumatic diseases are associated with anal fissures and should be suspected if fissures occur in unusual locations.

Who Gets Anal Fissures?

• Both men and women of any age can develop anal fissures.

• Women are more likely to get them during childbearing years or after childbirth.

• Constipation, passing hard stools, diarrhea, and trauma (including anal sex or childbirth) are common causes.

• Some medical conditions like Crohn's disease, infections, or previous anorectal surgery can also lead to fissures1.

Symptoms to Watch For

The primary symptom of anal fissures is pain during and following bowel movements. Other symptoms that may occur are:

• bleeding, itching, and malodorous discharge

• Sharp, cutting pain during or after bowel movements

• Bright red bleeding on the toilet paper or the toilet

• A visible tear or crack near the anus

• • Sometimes, a small lump or "sentinel pile" at the edge of the fissure1

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How Are Anal Fissures Treated?

Anal fissures are initially treated conservatively with home remedies and OTC products by:

Adding bulk to the stool, Softening the stool, Consuming a high fiber diet, Utilizing sitz bath Surgery by lateral sphincterotomy is the standard procedure for curing anal fissures. Because of complications, however, it is reserved for patients who are intolerant of non-surgical treatments or in whom non-surgical treatments have proven to be ineffective.

1. Conservative (Non-Surgical) Treatment

Dietary changes: Increase fiber and fluids to keep stools soft.
Sitz baths: Sitting in warm water helps relax the muscles and relieve pain.
Topical ointments: Use only topical ointments.
Laxatives: Help prevent constipation and reduce straining.

2. Surgical Treatment

If non-surgical methods fail (especially for chronic fissures), surgery may be recommended.

Lateral Internal Sphincterotomy (LIS): The gold standard. A small cut is made in the internal sphincter muscle to reduce spasms and promote healing. This can be done using a traditional scalpel, electrocautery, or a laser.

What is Laser Sphincterotomy?

Laser sphincterotomy is a modern, minimally invasive version of LIS. Instead of a scalpel, a precise laser fiber divides the internal sphincter muscle.

Benefits of Laser Sphincterotomy:

Bloodless field (less bleeding)
Precise cutting with immediate vessel sealing
Less tissue trauma and pain
Faster recovery
Lower risk of infection1
Pain less procedure
No cutting of extra tissue
No bleeding

The laser is used under direct vision, ensuring the correct amount of muscle is divided. This precision reduces the risk of complications and enhances healing.

Frequently Asked Questions (FAQs)

An anal fissure is a small tear or crack in the lining of the anal canal, often causing pain and bleeding during or after bowel movements.

Common causes include passing hard or large stools, chronic constipation, frequent diarrhea, trauma from childbirth, anal intercourse, and certain inflammatory conditions like Crohn's disease.

Sharp pain during or after bowel movements
Bright red blood on the stool or toilet paper
Itching or irritation around the anus
A visible tear or small lump (sentinel pile) near the anus.

A healthcare provider usually diagnoses it based on your symptoms and a gentle physical examination. Sometimes, a digital rectal exam is performed if tolerated.

Many acute fissures heal with simple measures like dietary changes, increased fluid intake, and sitz baths. Chronic fissures (lasting more than 6-8 weeks) may require further treatment.

A high-fiber diet and plenty of fluids
Stool softeners
Warm sitz baths
Topical ointments (e.g., nitroglycerin)
Pain relief medications.

Surgery is considered for chronic fissures that do not heal with conservative treatment. The most common procedure is lateral internal sphincterotomy, which can be performed with a scalpel or laser.

Laser treatment is a minimally invasive procedure where a focused laser is used to precisely cut the anal sphincter muscle, promoting healing and reducing pain. It usually results in less bleeding, minimal pain, and faster recovery than traditional surgery.

Most patients report minimal pain during and after the procedure. The treatment is typically performed under anesthesia; recovery is usually quicker and more comfortable than conventional surgery.

Most people can resume normal activities within a few days. Complete healing typically takes 1-2 weeks, but this may vary from person to person.

Laser surgery is generally very safe, but as with any procedure, there are risks, such as minor bleeding, swelling, or temporary discomfort. Serious complications like infection or incontinence are rare.

Recurrence is possible but less likely with laser treatment, especially if you maintain healthy bowel habits and address underlying causes like constipation.

Take prescribed painkillers and stool softeners.
Maintain good hygiene and keep the area dry
Eat a high-fiber diet and drink plenty of water
Avoid straining during bowel movements
Follow your doctor's instructions for wound care and follow-up visits.

Coverage varies depending on your insurance provider and policy. It is best to check with your insurer before the procedure.

Pain improves quickly after successful treatment, especially if the muscle spasm is relieved. However, complete healing may take a few weeks.

Yes, when performed by an experienced surgeon, laser sphincterotomy is safe and effective. It offers similar healing rates to traditional surgery but with less pain and bleeding1.

There is a very low risk for permanent issues, less than 1%. Some patients may have Temporary minor leakage, but this usually resolves independently.

Follow your surgeon's advice, which usually includes:
Taking sitz baths
Eating a high-fiber diet and drinking plenty of fluids
Using prescribed ointments or medications
Avoiding straining during bowel movements

Recurrence is possible, especially if constipation returns or underlying causes are not addressed. Maintaining good bowel habits is key to prevention.

Laser treatment is as effective as traditional surgery, with the added benefits of less pain, less bleeding, and quicker recovery. The choice depends on your surgeon's experience and your specific case.

If you have severe anal pain, bleeding, or symptoms that do not improve with home care, see a colorectal specialist for evaluation and treatment.

Diet Chart for Fissure-in-Ano (Anal Fissure)

A fiber- and fluid-rich diet helps heal anal fissures and prevent recurrence. This chart provides a full-day plan to ease bowel movement and reduce strain on the anal area.

Time	Meal	Options
Morning	Warm water	1 glass of warm water with a few soaked raisins or soaked almonds
Breakfast	High-fiber meal	Oats porridge with milk, whole wheat toast, fresh fruit (apple, papaya, banana)
Mid-morning	Fruit/juice	1 glass of fresh orange juice or a bowl of watermelon or muskmelon
Lunch	Balanced, fiber-rich meal	Brown rice or whole wheat chapati, dal (moong/masoor), sabzi (spinach, bottle gourd, carrot), salad (cucumber, tomato, carrot), a bowl of curd or buttermilk
Afternoon	Hydrating snack	Coconut water or buttermilk, a small bowl of soaked dry fruits
Evening	Light snack	Roasted chana, sprouts salad, or fruit like pear or apple
Dinner	easy-to-digest meal	Khichdi with vegetables, lauki (bottle gourd) curry, steamed broccoli, a glass of buttermilk
Bedtime	Bedtime Hydration	1 glass of lukewarm water

✅ Foods to Include

High-fiber foods: : Whole grains (brown rice, oats, barley, whole wheat bread), pulses, legumes, beans, peas, lentils, and root vegetables
Fruits: : Apples, oranges, pears, papaya, watermelon, berries, bananas, citrus fruits
Vegetables: Leafy greens (spinach, moringa), carrots, bottle gourd, cucumber, broccoli, ash gourd, bell peppers.
Nuts/seeds: Flax seeds, soaked almonds, walnuts.
Probiotics foods: Curd, buttermilk, lassi, fermented foods.
Hydrating foods: Watermelon, cucumber, oranges, coconut water.
Fluids: At least 8-10 glasses of water daily, fresh fruit juices, soups.

🚫 Foods to Avoid

Spicy, fried, and processed foods (chips, bakery items, cakes, pastries)
Red meat and non-vegetarian foods
Maida (refined flour) products
Caffeinated drinks (coffee, cola), alcohol
Dairy products (if they cause constipation)
Pickles, papad, and excessive spices
Junk food and soft drinks.

💡 Tips for Success

Gradually increase fiber intake to avoid bloating or gas
Chew food thoroughly and eat slowly.
Avoid heavy meals, especially in the evening.
Exercise regularly to promote bowel movements.
Consult your doctor before making major dietary changes, especially if you have other health conditions.

Fissure in ano

Laser Internal Sphincterotomy or LASER treatment is done when a patient suffers from a chronic fissure. During this surgery, the laser is used to create a small incision at the fissure site. This helps to relax the anal sphincter muscles, thereby healing the fissure.

ADVANTAGES

Early return to work, less painful, minor wounds, no bandages.

Contact Information

ADDRESS 408-A, Adarsh Nagar, Near Jain Bhawan,
Kapurthala Road, Jalandhar, INDIA (144008)

MOBILE +91 86999 15050

EMAIL info@karanhospital.com

What Our Patients Say

Dheeraj Wali

For the last 5 Years I had been suffering from pain and bleeding after defecation. I was afraid of surgery but somebody told me about the LASER treatment that Karan Hospital was offering. I am so glad to come here and now I am fully cured. Experience was excellent. Totally satisfied.

Gurmeet Ram

I got very good treatment for my piles with the LASER technique. No cuts, no stitches, my treatment went very smoothly.

Yadwinder Singh

I would like to thank Dr. Kamal Gupta. It was wonderful and unique experience. The charges were reasonable in comparison to the satisfaction and kind of service I received during my treatment.

Rakesh Kumar

Dr. K Gupta M.S. Sergon is a good person and he has good knowledge. The latest equipments, ensuring the best caring in this hospital and behavior of all the staff are good.

Understanding Anal Fissures and Laser Treatment

What is an Anal Fissure?

Causes Of Anal Fissure

Who Gets Anal Fissures?

Symptoms to Watch For

How Are Anal Fissures Treated?

1. Conservative (Non-Surgical) Treatment

2. Surgical Treatment

What is Laser Sphincterotomy?

Benefits of Laser Sphincterotomy:

Frequently Asked Questions (FAQs)

What is a fissure-in-ano (anal fissure)?

What causes an anal fissure?

What are the typical symptoms of an anal fissure?

How is an anal fissure diagnosed?

Can anal fissures heal on their own?

What are the non-surgical treatments for anal fissure?

When is surgery recommended for an anal fissure?

What is laser treatment for anal fissures?

Is laser fissure treatment painful?

How long does it take to recover from laser fissure surgery?

Are there any risks or side effects with laser fissure surgery?

Can fissures recur after treatment?

What precautions should I take after fissure treatment?

Is laser treatment for fissures covered by insurance?

Will my pain go away immediately after treatment??

Is laser surgery safe?

Are there risks of incontinence (leakage) after laser sphincterotomy?

What should I do at home after laser treatment?

Can fissures come back after treatment?

Is laser treatment better than traditional surgery?

When should I see a doctor?