Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients


  • Sajith Babu S. M. Department of Surgery, Shyam Shah Medical College, Rewa, Madhya Pradesh, India http://orcid.org/0000-0003-4012-5724
  • Rachna Gupta Department of Surgery, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
  • Lalmani Singh Department of Surgery, Shyam Shah Medical College, Rewa, Madhya Pradesh, India




Acute fissure in ano, Dietery fibre, Diltiazem ointment, Sitz bath


Background: Fissure-in-ano is a common yet troublesome condition; if acute, the severity of patient discomfort and extent of disability far exceed that would be expected from a seemingly trivial lesion. The present study was carried out to study the effectiveness of conservative management in symptom relief in acute fissure in ano.

Methods: The study was conducted in 165 patients with acute fissure in ano attending Surgery OPD and/or admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa during the period from 1st August 2015 to 31st July 2016. It was a prospective clinical study. All the study subjects underwent extensive clinical examination and were prescribed conservative treatment regime. Follow up was done at the end of 2 weeks, 4 weeks and 6 weeks and the data was analyzed. 165 patients diagnosed as having acute fissure in ano. The outcome was assessed based on the following parameters; symptomatic relief, pain relief based on visual analogue scale and healing of ulcer.

Results: Most of the patients were young adults with a slight female dominance. Pain during defecation and bleeding per rectum were the major presenting complaints. 73.94% of patients achieved symptom relief within 2 weeks of conservative treatment. At 6 weeks follow up after giving conservative line of management, 97.58% achieved symptom relief with healing of ulcer. Mean pain score was reduced from 9.5±0.71 at the start of therapy to 1.33±0.69 at the end of 6 weeks of conservative therapy.

Conclusions: Acute fissure in ano can be easily cured with systematic usage of conservative treatment regime. A proper follow up along with patient education can help to achieve good remission and avoid unnecessary surgical intervention.


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