Colorectal Surgery

Question 1

What’s the treatment for acute anal fissures?

Answer 1

Advise high fibre and fluid

1) bulk forming laxative eg ispaghula husk (if not tolerated try lactulose)
2) lubricants pre dedication and topical anaesthetics

Question 2

What’s the management for a chronic anal fissure?

Answer 2

Acute techniques plus
1) topical GTN
If not effective after 8 weeks refer for surgery/ Botox

Question 3

What’s dukes criteria?

Answer 3

5 year survival

0- 
1 -90%
2 - 70%
3 - 30%
4 - 5%