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00:06Assalam-o-Alaikum, my name is Dr. Vasanth Majid Chaudhary
00:08I am working as a consultant surgeon
00:10at Surgement Hospital, Lahore.
00:12Today, I will talk to you
00:14about anal fissure
00:16in detail.
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00:36easily.
00:58If I come to the reasons,
01:00the most common reason
01:02is constipation.
01:04Permanent constipation.
01:06Patients who have constipation
01:08at any time
01:10when they have to apply
01:12force,
01:14because of that force,
01:16severe constipation
01:18in the back of the
01:20bowel,
01:22it comes out tearing
01:24and makes a wound there.
01:26One reason is
01:28severe constipation due to constipation
01:30and it makes a wound there.
01:32Second, if some people
01:34have diarrhea
01:36or have
01:38a lot of
01:40watery stool,
01:42that too, because of
01:44coming again and again,
01:46it makes a wound in the back of the bowel,
01:48which is called anal fissure.
01:50Third,
01:52the most important reason among women
01:54is that
01:56during delivery,
01:58when the child's head
02:00reaches down,
02:02due to its pressure,
02:04pressure comes on the front
02:06side of the bowel
02:08and this cut
02:10in those pregnant women
02:12comes forward.
02:14These three are very common reasons
02:16for anal fissure.
02:18If we talk about its symptoms,
02:20the most common
02:22symptom is pain
02:24along the way of delivery.
02:26This pain is very severe
02:28and
02:30along with this,
02:32blood often comes
02:34which, along with
02:36the end of delivery,
02:38mixes with
02:40diarrhea.
02:42If I
02:44want to differentiate
02:46this with diarrhea,
02:48then in diarrhea,
02:50blood comes in the form of
02:52diarrhea, whereas
02:54in anal fissure,
02:56mixed with diarrhea,
02:58blood comes in the form of
03:00a streak.
03:02The amount of blood is not much,
03:04often three to four drops,
03:06whereas in diarrhea,
03:08the amount of blood is more.
03:10These are the two
03:12common symptoms
03:14with which anal fissure
03:16presents.
03:18These are the symptoms
03:20and there is no need
03:22for long-term
03:24investigations
03:26to diagnose it.
03:28If a certified surgeon
03:30examines the outside and inside
03:32of the anus,
03:34it can be easily diagnosed.
03:36When the surgeon examines it,
03:38if we separate
03:40the anus a little,
03:42the posterior
03:44anal fissure,
03:46which is called the posterior fissure,
03:48can be seen clearly.
03:50Similarly, if we separate the anterior
03:52anal fissure,
03:54which is called the anterior anal fissure,
03:56it can be seen easily.
03:58There is no need for
04:00any investigation or ultrasound.
04:02When it is diagnosed,
04:04its treatment
04:06is non-surgical
04:08in about 80% of the patients.
04:10There is no need for surgery.
04:12There are medicines
04:14that can be used
04:16to treat it easily.
04:1880% of the patients
04:20are cured with those medicines.
04:22The remaining 15-20%
04:24of the patients
04:26who are not able to
04:28use the medicines properly
04:30or due to some reason
04:32they are not healed,
04:34they have to go for surgery.
04:36There are two ointments
04:38in the treatment
04:40which we mix and apply
04:42on the anterior anal fissure.
04:44It has to be done
04:46for 3-4 weeks.
04:48Along with this,
04:50the diet has to be modified.
04:52For example,
04:54the balanced diet
04:56in which
04:58carbohydrate,
05:00proteins and fats
05:02are used in an appropriate amount.
05:048-10 glasses of water
05:06should be taken daily.
05:08After that,
05:10fast food,
05:12pizza and burgers
05:14should be avoided.
05:16In addition,
05:18the bulk of the food
05:20that is cooked
05:22in the diet
05:24should be used
05:26before going to bed.
05:308-10 glasses
05:32of water
05:34should be taken
05:36daily.
05:38The content
05:40of the water
05:42in the stool
05:44is very good
05:46and there is no problem
05:48in fasting.
05:50For those people
05:52who are not able to
05:54digest food properly,
05:56we give them some
05:58syrups which
06:00make the food soft
06:02and the stools
06:04become soft.
06:06These are some precautions
06:08and if the pain
06:10is very severe,
06:12then we give
06:14the patient
06:16painkillers
06:18and usually
06:20the pain
06:22of the anal fissure
06:24goes away.
06:26If all the precautions
06:28that I have told you
06:30are not
06:32correct
06:34then we have to
06:36go for the surgery.
06:38The surgery is very simple
06:40and the reason
06:42is that the
06:44way of cooking
06:46is tight
06:48and when the food
06:50is cooked
06:52hard, it hurts
06:54the patient.
06:56So, we have to
06:58relax the tight way
07:00of cooking
07:02and when we cut
07:04the mechanism of
07:06cooking,
07:08the way of cooking
07:10opens up
07:12and the food
07:14is cooked easily
07:16and we get time
07:18to fill the wound.
07:20So, this is a small operation
07:22for which
07:24there is no need
07:26of long investigations.
07:28We do this as a day case procedure.
07:30We send the patient
07:32home in the evening.
07:34This can be done in complete unconsciousness
07:36and it can be done
07:38through spinal anaesthesia.
07:40The healing
07:42after the surgery
07:44is very good
07:46and the patient can resume
07:48his daily activities from the next day.
07:50If you want to know
07:52anything else about this disease
07:54or if you want to contact us for treatment,
07:56then you can call
07:58and make an appointment with us.
08:00Thank you!
08:28www.ottobock.com