A PROSPECTIVE STUDY OF ACUTE FISSURE-IN-ANO IN RELATION TO CLINICAL DIAGNOSIS AND MANAGEMENT

An anal fissure is a longitudinal ulcerated area in the vertical axis of the squamous lining of the anal canal between the anal verge and the dentate line, noted in 10–15% of proctological patients. Present study was aimed to study, acute fissure-in-ano in relation to clinical diagnosis and management at a tertiary hospital.  Present study was hospital based prospective observational study, conducted in patients between 18-70 years of age ( including males & females ), with symptoms of pain on defecation, bright red bleeding, constipation (i.e. suspected cases of acute anal-fissure). Among 100 subjects, 47 % subjects were between aged 31-40 years. mean age of study subjects was 36.44 ± 3.2 years. Out of 100 patients,51% were males and 49% were females. Posterior fissure in ano was present in 90% of males and anterior fissure was present in 20% females. Also concomitant fissures were present in 6% females. 75% Patients (70% male and 80% female) were pain-free after 2 weeks of medical line of management. 84% Patients (84% males and females each) were pain-free after 4 weeks of medical line of management. 91% Patients (92% males and 90% females) were pain-free after 6 weeks of medical line of management. Out of 100 patients, 4% (males and females) undergone surgery (lateral internal sphincterotomy) after 8 weeks of medical line of management and relieved of symptoms. Acute fissure-in-ano, can be treated with medical (conservative) line of management, which is effective, cheaper and feasible way of treatment. Those who are still symptomatic can undergo surgery (lateral internal sphincterotomy).