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Colorectal Diseases

Chronic Anal Fissure

10/12/2011

Question:

I had colorectal cancer 11 years ago. Radiation to area which was within digital reach of anus. Plus chemo and surgery to remove tumor area. Two years ago I got an anal fissure which will NOT heal. Surgeon says area was burned with radiation, and skin will not stretch without causing the fissure. Have used Lidocain and vaseline. It is so extremely painful, I cry and become so stressed that I feel worse. Have depression already. Can you recommend ANYTHING to heal this fissure? Will I have it forever since skin has been radiated? I have surgeons opinion, but I want a second opinion. Maybe she is missing something. Thank you.

Answer:

Radiated tissue will always be more difficult to heal than non-radiated tissue.

There are a few additional things to try to relieve your pain: Certain topical ointments, containing nifedipine, diltiazem, or nitroglycerine can relax the internal sphincter and relieve pain. O

Occasionally Botox can be injected into the fissure to relieve the pain.

Obviously stool softeners and fiber are the mainstay of therapy. Would try to avoid surgery if possible, again due to the risk of non-healing wound, and fecal incontinence.

Good luck

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Response by:

Janice Frederick Rafferty, MD Janice Frederick Rafferty, MD
Professor of Surgery
Chief of Colorectal Surgery Division
College of Medicine
University of Cincinnati