Affiliation:
1. PG Student 3rd Year, S.S. M.C. & Sanjay Gandhi Memorial Hospital, Rewa
2. Assistant Professor, S.S. M.C. & Sanjay Gandhi Memorial Hospital, Rewa
3. Senior Resident, S.S. M.C. & Sanjay Gandhi Memorial Hospital, Rewa
Abstract
Introduction:Anal ssures are longitudinal tears in the squamous epithelium of the anal canal. Anal ssures are located distal to the dentate line,
and in around 90% of cases they are located on the posterior midline. The most common pathologies of the anorectal region and can change the
quality of life as it causes patient pain and emotional stress while defecation. With a lifetime risk of 11%, anal ssure is a common problem in
routine medical care. Anal ssure is mainly treated by relaxing the spasm of the internal sphincter either by dilating the anal canal or
sphincterotomy. Reduction of spasticity of anal sphincters is the special treatment for ssure healing. For this purpose, the treatment of anal ssures
is performed by lateral sphincterotomy or by anal dilatation. Methods: Out of 100 randomly selected 50 patients with inclusion and exclusion
criteria and informed consent were treated with nifedipine ointment and 50 patients with informed consent were treated with lateral sphincterotomy
for management of anal ssure. Observations after treatment were recorded at second week, sixth week and twelfth week interval for bleeding, pain
and healing and at the twelfth week follow up was documented to analyse the result of treatment. Result: Out of 50 patients undergoing
treatment with Nifedipine ointment 42 patients healed completely. 36 patients in the nifedipine group had complaint of bleeding, after treatment
with nifedipine ointment 30 patients were relieved from bleeding while 6 were complaining of bleeding on follow up after 3 months. Patients in
lateral sphincterotomy group underwent surgery under spinal anaesthesia. In lateral sphincterotomy group, ssure healing was found in 49
(98%)out of 50 patients. In our study out of 50 patients, 48 (96%)were completely relieved from pain and 2 ( 4% ) had pain on follow up at the
end of 3 months. In our study , in the lateral sphincterotomy group 34 patients out of 50 patients were complaining of bleeding and
after surgery 32 were relieved from bleeding within 12 weeks and 2 were complaining of bleeding. Conclusion:Topical 2% nifedipine should be
given as the rst option of treatment for anal ssure. Lateral sphincterotomy, which gives better result to relieve the symptoms but require
hospitalization, should be offered to patient who present with relapse and does not respond to pharmacological treatment.