Sarah J. Kerr, BA
This is a procedure to treat chronic anal fissures. An anal fissure is a painful tear in the lining of the anus. The anus is the opening through which stool passes from the body. Tears generally occur just inside the opening.
Muscle spasms in the rectum can prevent fissures from healing. A sphincterotomy relieves these muscle spasms. Anal fissures often heal by taking certain steps, such as:
When these do not work, a sphincterotomy may be done. This procedure allows the fissure to heal and decreases pain and spasms. Pain will begin to go away within a few days.
Complications are rare. But, no procedure is completely free of risk. If you are planning to have a sphincterotomy, your doctor will review a list of possible complications, including:
may increase the risk of complications.
Before surgery, your doctor may do the following determine the extent of your fissure:
In the days leading up to the surgery, your doctor may:
You should also talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
Depending on which option is best for you, your doctor may give you:
If there are any skin tags near the fissure, they will be removed. Next, the doctor will carefully make a cut on the anal sphincter muscle. This will relax the sphincter and allow it to stretch, taking pressure off the fissure. The doctor will put a dressing into your anus to stop the bleeding.
Less than one hour
During the procedure, pain will be managed with a general or local anesthetic. The pain from your fissures will begin to go away in a few days. Your doctor may prescribe pain medication to help you feel more comfortable.
You may be given pain medications and instructions for how to care for your rectal area. A nurse may change your dressing or instruct you on how to change it.
When you return home, follow your doctor's instructions for a smooth recovery, such as:
After arriving home, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
American Society of Colon & Rectal Surgeons
American Academy of Family Physicians
Canadian Society of Colon and Rectal Surgeons
The College of Family Physicians of Canada
Anal fissure. American Society of Colon & Rectal Surgeons website. Available at:
http://www.fascrs.org/patients/conditions/anal_fissure/. Updated October 2012. Accessed May 28, 2013.
Anal fissure. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated November 20, 2012. Accessed May 28, 2013.
Anal fissure/fistulotomy/sphincterotomy surgery. University of Wisconsin School of Medicine and Public Health, UW Health website. Available at:
http://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember-Show_Public_HFFY_1105646271830.html. Updated April 24, 2013. Accessed May 28, 2013.
Anal fissures. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/disorders/anal_fissures/hic_anal_fissures.aspx. Updated April 19, 2010. Accessed May 28, 2013.
Anal fissures. University of California San Francisco Medical Center website. Available at:
http://www.ucsfhealth.org/education/anal_fissures/. Accessed May 28, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
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Last reviewed May 2013 by Marcin Chwistek, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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