Anal fissure fissure-in-ano is a very common anorectal condition. The exact etiology of this condition is debated; however, there is a clear association with elevated internal anal sphincter pressures. Though hard bowel movements are implicated in fissure etiology, they are not universally present in patients with anal fissures. Half of all patients with fissures heal with nonoperative management such as high fiber diet, sitz baths, and pharmacological agents. When nonoperative management fails, surgical treatment with lateral internal sphincterotomy has a high success rate. In this chapter, we will review the symptoms, pathophysiology, and management of anal fissures.
Piles: Symptoms, causes, and treatments
Long Beach, Calif. Leon Banov, and also of your editor , ; , ? The sentinel pile was not described by Sir Benjamin Brodie, and so it is not surprising that the 19th-century textbooks on rectal diseases make no mention of it in association with Brodie's name. The little torment was, however, described by Sir Charles Ball, professor of surgery at the University of Dublin. He first propounded his theory as to its causation in cases of fissure in his book, The Rectum and Anus: Their Diseases and Treatment.
Steven G. An anal fissure is a linear ulcer usually extending from just below the ano-rectal line to the margin of the anus. The pain associated with fissure disease is disportionate to the size of the lesion with post-defecatory pain intense burning lasting anywhere from minutes to hours. There is pathology that is consistent with the fissure disease and chronicity usually dictates its extent. The etiology of the fissure disease is usually passage of a large stool or prolonged straining over a period of time chronic constipation.