Fissures

Question 1

anal fissure

Answer 1

tear ir ulcer in lining of anal canal

Question 2

anal fissure symptoms

Answer 2

~ bleeding
~ sharp, persistent pain on defecation
~ linear split in anal mucosa

Question 3

acute anal fissure tx

Answer 3

~ <6 weeks
~ bulk-forming / osmotic
~ short-term topical local anesthetic i.e. lidocaine

Question 4

chronic anal fissure

Answer 4

> 6 weeks
~ GTN rectal ointment (SE = headache)
~ 2nd line = oral/topical diltiazem, nifedipine