Triple approach in the non-operative treatment of anal fissure: Fiber-rich nutrition-Hot water sitz bath-Self massage

Abstract

Anal fissure constitutes an important part of proctological applications to surgery outpatient clinics. Despite its prevalence, diagnosis and treatment remains a challenge in many respects. Today, the recommendation of clinical guidelines is to prefer conservative treatments as the first choice in anal fissures. Hot water sitz bath, anal sphincter massage with finger and prevention of constipation can be counted among the basic principles. In this study, we sought to answer the question of whether the application of this triple application together with topical ointments increases success or not. The data of 134 anal fissure cases treated and followed up in the general surgery outpatient clinic were analyzed retrospectively. The relationship between treatment compliance and response to treatment in cases treated conservatively with topical drug application, regulation of diet and bowel habits, hot water sitz bath and finger anal massage trio was not statistically significant (p= 0.08). Response to treatment was found to be significantly higher in patients who regularly applied anal massage (p= 0.038) and sitz bath (p= 0.001). In conclusion, it can be said that emphasizing the sitz bath and informing the patients about the relaxing of the anorectal sphincter are the keys to success in the treatment.