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Anal fissure & fistula

Fissura ani et fistula ani · Anální fisura a píštěl

What it is

A tear or an abnormal tunnel in the anal canal — small, and extremely painful.

Symptoms & signs

  • Sharp pain on defecation lasting hours
  • bright blood
  • spasm
  • discharge in fistula

🚩 Get help if…

  • see a doctor soon Fever with a painful, swollen lump near the anus (abscess)
  • see a doctor soon Pus or stool leaking from an opening near the anus
  • see a doctor soon Heavy bleeding or dark blood mixed in stool
  • see a doctor soon A fissure not healed after 6 weeks, or with weight loss

Where it strikes

Medical treatment

  • Topical GTN or diltiazem
  • botulinum injection
  • lateral sphincterotomy
  • seton or LIFT procedure for fistula

Natural & lifestyle

  • Soften the stool (fibre, macrogol)
  • sitz baths
  • avoid straining
  • hydration

Emerging & experimental

  • Fistula plugs and stem-cell therapy (darvadstrocel failed its confirmatory trial)
  • laser fistula closure

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Honey, beeswax and olive-oil ointment — a small trial helped fissures and haemorrhoids early / small studies
  • Coconut oil — anecdotal anecdotal / traditional

ICD codes