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Anal fissures can be acute or chronic. An acute fissure is a superficial tear and a short-term condition. A chronic fissure is deeper and may expose underlying muscle. When lifestyle and diet changes and medication fail, and the condition becomes chronic, surgery is recommended.

Esther Ahyoung Kim
(402) 559-5510
983280 Nebraska Medical Ctr
Omaha, NE
Mohammed A Quader
(402) 559-9800
988095 Nebraska Medical Ctr
Omaha, NE
Quan P Ly
(402) 559-9800
988095 Nebraska Medical Ctr
Omaha, NE
Luciano M Vargas, MD
Omaha, NE
Dmitry Oleynikov, MD
402-559-5508
983280 Nebraska Medical Ctr
Omaha, NE
Aaron Raphael Sasson, MD
402-559-8941
983280 Nebraska Medical Ctr
Omaha, NE
Michael Miloro, MD
402-559-5326
985180 Nebraska Medical Ctr
Omaha, NE
Wendy Jean Grant, MD
402-850-4011
983285 Nebraska Medical Ctr
Omaha, NE
Debra Clausing Sudan, MD
402-559-6132
983285 Nebraska Medical Ctr
Omaha, NE
Janel L Kunza
(402) 559-4000
983280 Nebraska Medical Ctr
Omaha, NE
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Sphincterotomy and Anal Fissure

Overview

A fissure is a tear in the skin of the anus, usually caused when a large, hard stool overstretches the anal opening and damages the fragile skin. It is often associated with constipation, and less frequently, with chronic diarrhea, inflammatory bowel disease or sexually transmitted diseases that involve the anus and rectum. Sometimes, the cause is unknown.

Anal fissures can be acute or chronic. An acute fissure is a superficial tear and a short-term condition. A chronic fissure is deeper and may expose underlying muscle. When lifestyle and diet changes and medication fail, and the condition becomes chronic, surgery is recommended. A lateral internal sphincterotomy is the surgical procedure most commonly used to repair a fissure.

Surgical Procedure

Lateral internal sphincterotomy involves stretching or cutting the internal sphincter, the muscle that restricts and relaxes when stool passes from the body. Cutting the muscle prevents spasm and temporarily weakens the muscles, and this in turn helps the area to heal. The surgeon removes the fissure and any underlying scar tissue.

The surgery can be performed under local anesthesia, which involves injecting the immediate area with a numbing agent similar to that used at the dentist's office, or spinal anesthesia, which numbs the entire lower body. In some cases, general anesthesia may be used, which renders the patient unconscious. The choice of anesthesia depends on patient and physician preference, the pa...

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