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Anal Fissure Treatment - Types, Symptoms, Risks & Complications

An anal fissure is a small tear or cut in the thin, moist tissue that lines the anus. Anal fissures are one of the most common anorectal conditions and can be quite painful as the damage in the skin can often pull apart and even worsen the situation. Struggling... View More with an anal fissure? Get in touch with us and book your appointment with our highly experienced proctologists at Medifee today!

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What is an Anal Fissure?

An anal fissure is a small tear or cut in the thin, moist tissue that lines the anus. Anal fissures are one of the most common anorectal conditions and can be quite painful as the damage in the skin can often pull apart and even worsen the situation. Bowel conditions like chronic diarrhoea or constipation can also make an anal fissure worse,

Some of the most common causes of an anal fissure include constipation, persistent diarrhoea, passing large or hard stools during bowel movements and inflammatory bowel diseases (IBD) such as Crohn’s disease or ulcerative colitis.

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Dr. Ramnik Grover
Dr. Ramnik Grover

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29 Yrs. Exp.

₹500FREE Consultation

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4.8/5

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Delhi

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Dr. Sanjeev Gupta
Dr. Sanjeev Gupta

MBBS, MS- General Surgeon

25 Yrs. Exp.

₹1500FREE Consultation

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4.9/5

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25+ Years

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Delhi

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Dr. Milind Joshi
Dr. Milind Joshi

MBBS, MS - General Surgery

25 Yrs. Exp.

₹1500FREE Consultation

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4.9/5

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Dr. Amol Gosavi
Dr. Amol Gosavi

MBBS, MS - General Surgery

23 Yrs. Exp.

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4.7/5

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Mumbai

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Dr. Himanshu Kumar Choudhary
Dr. Himanshu Kumar Choudhary

MBBS, MS-General Surgery

22 Yrs. Exp.

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4.7/5

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Ranchi

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Dr. Vummineni Suresh Kumar
Dr. Vummineni Suresh Kumar

MBBS, DNB-General Surgery

21 Yrs. Exp.

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4.7/5

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Vijayawada

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Dr. Sunil Raghunath Rai
Dr. Sunil Raghunath Rai

MBBS, MS, DNB

20 Yrs. Exp.

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4.5/5

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20+ Years

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Mumbai

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Dr. Pankaj Sareen
Dr. Pankaj Sareen

MBBS, MS - General Surgery

20 Yrs. Exp.

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4.9/5

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Delhi

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Dr. S. Kumarswamy
Dr. S. Kumarswamy

MBBS, MS-General Surgery

20 Yrs. Exp.

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4.7/5

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Coimbatore

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Dr. Sajeet Nayar
Dr. Sajeet Nayar

MBBS, MS - General Surgery

19 Yrs. Exp.

₹1200FREE Consultation

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4.6/5

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19+ Years

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Bangalore

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Dr. Ravi Sharma
Dr. Ravi Sharma

MBBS, DNB - General Surgery

19 Yrs. Exp.

₹1200FREE Consultation

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4.5/5

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Bhubaneswar

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Dr. Pankaj Waykole
Dr. Pankaj Waykole

MBBS, MS - General Surgery

19 Yrs. Exp.

₹1200FREE Consultation

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4.8/5

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19+ Years

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Pune

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Dr. Saibal Chakraborty
Dr. Saibal Chakraborty

MBBS, MS-General Surgery

18 Yrs. Exp.

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4.8/5

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Kolkata

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Dr. SJ Haridarshan
Dr. SJ Haridarshan

MBBS, MS - General Surgery

18 Yrs. Exp.

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4.8/5

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Bangalore

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Dr. M.Kudiyarasu
Dr. M.Kudiyarasu

MBBS, MS - General Surgery

18 Yrs. Exp.

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4/5

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Chennai

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Dr. Talluri Suresh Babu
Dr. Talluri Suresh Babu

MBBS, MS - General Surgery, FMAS

17 Yrs. Exp.

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4.6/5

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Hyderabad

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Dr. Bineet Jha
Dr. Bineet Jha

MBBS,F.C.P.S (SURG.)

17 Yrs. Exp.

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4.5/5

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Mumbai

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Dr. Gaurav Bharadwaj
Dr. Gaurav Bharadwaj

MBBS, MS-General Surgery

16 Yrs. Exp.

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4.8/5

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Lucknow

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Dr. Rakesh Kumar
Dr. Rakesh Kumar

MBBS, MS

16 Yrs. Exp.

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4.5/5

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Delhi

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Dr. Vikranth Suresh
Dr. Vikranth Suresh

MBBS, MS - General Surgery

16 Yrs. Exp.

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Bangalore

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Dr. Varun Gupta
Dr. Varun Gupta

MBBS, MS - General Surgery

16 Yrs. Exp.

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Chandigarh

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Dr. Qaisar Jamal
Dr. Qaisar Jamal

MBBS, MS - General Surgery

15 Yrs. Exp.

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4.9/5

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Patna

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Dr. Abdul Mohammed
Dr. Abdul Mohammed

MBBS, DNB - General Surgery

15 Yrs. Exp.

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Dr. Sree Kanth Matcha

MBBS, MS

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Dr. Asik Iquebal
Dr. Asik Iquebal

MBBS, MS-General Surgery

15 Yrs. Exp.

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Dr. Sathya Deepa
Dr. Sathya Deepa

MBBS, MS-General Surgery

15 Yrs. Exp.

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Dr. Raja H
Dr. Raja H

MBBS, MS, DNB- General Surgery

15 Yrs. Exp.

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Dr. Sunil Joseph
Dr. Sunil Joseph

MBBS, MS, MMIP (Proctology)

14 Yrs. Exp.

₹1000FREE Consultation

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4.5/5

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Dr. Sanjit Gogoi
Dr. Sanjit Gogoi

MBBS, MS - General Surgery

14 Yrs. Exp.

₹1000FREE Consultation

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4.6/5

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14+ Years

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Bangalore

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Dr. Rohan Kamalakar Umalkar
Dr. Rohan Kamalakar Umalkar

MBBS, MS-General Surgery

13 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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13+ Years

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Nagpur

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Dr. Uday Shankar Baluni
Dr. Uday Shankar Baluni

MBBS, MS-General Surgery

13 Yrs. Exp.

₹500FREE Consultation

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4.9/5

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13+ Years

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Dr. Yanshul Rathi
Dr. Yanshul Rathi

MBBS, MS - General Surgery

13 Yrs. Exp.

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4.5/5

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Delhi

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Dr. Sasidhara Rao A
Dr. Sasidhara Rao A

MBBS, MS - General Surgery

13 Yrs. Exp.

₹1000FREE Consultation

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4.5/5

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13+ Years

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Hyderabad

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Dr. Javed Akhter Hussain
Dr. Javed Akhter Hussain

MBBS, MS-General Surgery

13 Yrs. Exp.

₹1000FREE Consultation

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4.9/5

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Dr. Piyush Gulabrao Nikam
Dr. Piyush Gulabrao Nikam

MBBS,MS-General Surgery, FMAS (MUHS), FIAGES

13 Yrs. Exp.

₹500FREE Consultation

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4.5/5

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13+ Years

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Delhi

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Dr. Ashish Vora
Dr. Ashish Vora

MBBS, MS - General Surgery, FIAGES, FMAS

13 Yrs. Exp.

₹1000FREE Consultation

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5/5

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13+ Years

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Indore

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Dr. Mufsil P P
Dr. Mufsil P P

MBBS, MS-General Surgery

12 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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Kozhikode

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Dr. Kamal Kumar Shivram Shukla
Dr. Kamal Kumar Shivram Shukla

MBBS, MS-General Surgery

12 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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Mumbai

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Dr Lodhe Sonal Ramkrishna
Dr Lodhe Sonal Ramkrishna

MBBS, MS-General Surgery

12 Yrs. Exp.

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4.7/5

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Mumbai

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Dr. Sethu Kannan Ramasamy
Dr. Sethu Kannan Ramasamy

MBBS.,M.S., Dip MAS, FALS (Hernia) , FIAGES

12 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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12+ Years

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Madurai

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Dr. Akash Dua
Dr. Akash Dua

MBBS, MS-General Surgery

12 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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12+ Years

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Delhi

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Dr. Ashish Anand
Dr. Ashish Anand

MBBS, MS-General Surgery

12 Yrs. Exp.

₹500FREE Consultation

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4.8/5

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12+ Years

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Lucknow

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Dr. Shambhav Chandra
Dr. Shambhav Chandra

MBBS, MS- General Surgery

12 Yrs. Exp.

₹1000FREE Consultation

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4.5/5

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12+ Years

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Delhi

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Dr. Bharath Dath Anche T R
Dr. Bharath Dath Anche T R

MBBS, MS-General Surgery

12 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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12+ Years

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Bangalore

General Surgeon

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Dr. Antony Chacko
Dr. Antony Chacko

MBBS, MS-General Surgery

12 Yrs. Exp.

₹500FREE Consultation

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4.5/5

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12+ Years

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Kozhikode

General Surgeon

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Dr. Prudhvinath
Dr. Prudhvinath

MBBS, DNB - General Surgery

12 Yrs. Exp.

₹1000FREE Consultation

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4.8/5

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12+ Years

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Hyderabad

General Surgeon

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Dr. Amal Abraham
Dr. Amal Abraham

MBBS, MS, FMAS, FACS

12 Yrs. Exp.

₹1000FREE Consultation

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4.5/5

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12+ Years

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Kochi

GS

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vascular

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Dr. Emmanuel Stephen J
Dr. Emmanuel Stephen J

MBBS, MS

12 Yrs. Exp.

₹1000FREE Consultation

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4.6/5

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12+ Years

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Coimbatore

General Surgeon

Laparoscopic Surgeon

Vascular Surgeon

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Dr. P. Thrivikrama Rao
Dr. P. Thrivikrama Rao

MBBS, MS-General Surgery

11 Yrs. Exp.

₹1000FREE Consultation

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4.9/5

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11+ Years

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Hyderabad

General and Laparoscopic Surgeon

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Dr. Kakarla Sreelasya
Dr. Kakarla Sreelasya

MBBS, MS-Obs & Gyne

11 Yrs. Exp.

₹500FREE Consultation

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4.8/5

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11+ Years

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Hyderabad

Obstetrician

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Dr. Chetan Dayaram Rathod
Dr. Chetan Dayaram Rathod

MBBS, MS-General Surgey

11 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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11+ Years

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Mumbai

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Dr. Mohan Ram
Dr. Mohan Ram

MBBS, MS - General Surgery

10 Yrs. Exp.

₹800FREE Consultation

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4.5/5

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10+ Years

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Bangalore

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Dr. Naveed Pasha Sattar
Dr. Naveed Pasha Sattar

MBBS, MS, DNB- General Surgery

10 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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10+ Years

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Bangalore

General Surgeon

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Dr Nandhini
Dr Nandhini

M.B.B.S., M.S. (GENERAL SURGERY), DNB, Dip (LAP), FIAGES

10 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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10+ Years

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Chennai

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Dr. Sambit Kumar Mohanty
Dr. Sambit Kumar Mohanty

MBBS, MS-General Surgery

10 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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10+ Years

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Bhubaneswar

General Surgeon

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Dr. Ashwin Kumar Aouchat
Dr. Ashwin Kumar Aouchat

MBBS, MS-General Surgery

10 Yrs. Exp.

₹500FREE Consultation

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4.5/5

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10+ Years

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Indore

General Surgeon

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Dr. Aditi K
Dr. Aditi K

MBBS, MS (GENERAL SURGERY), FIAGES, FMAS

9 Yrs. Exp.

₹800FREE Consultation

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4.5/5

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9+ Years

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Bangalore

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Dr Sachin
Dr Sachin

MBBS, MS-General Surgery

9 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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9+ Years

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Bangalore

General Surgeons

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Dr. Anand Pandyaraj
Dr. Anand Pandyaraj

MBBS, MS- General Surgery

9 Yrs. Exp.

₹500FREE Consultation

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4.5/5

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9+ Years

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Chennai

General Surgeon

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Dr. Chandana Krunal Dineshbhai
Dr. Chandana Krunal Dineshbhai

MBBS, MS-General Surgery

9 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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9+ Years

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Ahmedabad

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Dr. Anjali Bhartiya
Dr. Anjali Bhartiya

MBBS, DNB-General Surgery

9 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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9+ Years

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Jaipur

General Surgeon

Laparoscopic Surgeon

Proctologist

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Dr. Tushar Goel
Dr. Tushar Goel

MBBS, MS-General Surgery, FMAS, DGE (Kiel Germany)

9 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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9+ Years

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Delhi

General Surgeon

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Dr. Parag Nawalkar
Dr. Parag Nawalkar

MBBS, MS-General Surgery

9 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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9+ Years

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Pune

General Surgeon

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Dr. K Lakshmi Chandra Sekhar
Dr. K Lakshmi Chandra Sekhar

MBBS, MS- General Surgery

9 Yrs. Exp.

₹800FREE Consultation

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4.5/5

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9+ Years

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Vijayawada

General Surgeon

Proctologist & Laparoscopic

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Dr. Mir Zeeshan Ali
Dr. Mir Zeeshan Ali

MBBS, MS

9 Yrs. Exp.

₹800FREE Consultation

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4.5/5

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9+ Years

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Bangalore

General Surgeon

Proctologist & Laparoscopic

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Dr. Thota Karthik
Dr. Thota Karthik

MBBS, MS-General Surgery, FMAS

9 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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9+ Years

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Hyderabad

General Surgeon

Proctologist

Laparoscopic Surgeon

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Dr. Janhavi Parulkumar Kapadia
Dr. Janhavi Parulkumar Kapadia

MBBS, DNB-General Surgery

9 Yrs. Exp.

₹500FREE Consultation

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4.8/5

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9+ Years

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Mumbai

General Surgeon

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Dr Dumpa Shruthi
Dr Dumpa Shruthi

MBBS, MS General Surgery, FALS,

8 Yrs. Exp.

₹500FREE Consultation

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4.7/5

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8+ Years

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Hyderabad

General Surgeon

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Dr Amit Kukreti
Dr Amit Kukreti

MBBS- MS- General Surgery

8 Yrs. Exp.

₹500FREE Consultation

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4.8/5

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8+ Years

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Delhi

General Surgeon

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Dr. Vishal Anil Chawda
Dr. Vishal Anil Chawda

MBBS, MS-General Surgery

8 Yrs. Exp.

₹500FREE Consultation

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4.5/5

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8+ Years

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Mumbai

General Surgeon

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Dr. Tagore .V
Dr. Tagore .V

MBBS, MS-General Surgery

8 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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8+ Years

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Visakhapatnam

General Surgeon

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Dr. Joyner Abraham M
Dr. Joyner Abraham M

MBBS, MS, DNB, M.Ch-- General Surgery

8 Yrs. Exp.

₹500FREE Consultation

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4.5/5

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8+ Years

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Chennai

General Surgeon

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Dr. Abilash M
Dr. Abilash M

MBBS, MS-General Surgery, FMAS

8 Yrs. Exp.

₹500FREE Consultation

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4.6/5

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8+ Years

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Chennai

General Surgeon

Laparoscopic Surgeon

Proctologist

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Dr. Lohit Sai K
Dr. Lohit Sai K

MBBS, M.S.(Gen. Surgery), DNB (Gen. Surgery), F.MAS, D.MAS, FAIS, FALS, FIAGES

8 Yrs. Exp.

₹500FREE Consultation

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Types of Anal Fissure

There are primarily 2 types of anal fissures: 

  • Acute anal fissure: An acute anal fissure is one of the most common types of fissures and looks very fresh and similar to a paper cut. Most acute fissures heal on their own within 5-6 weeks and do not require surgical intervention but if the condition persists, your surgeon may recommend surgery.
  • Chronic anal fissure: In comparison to acute anal fissures, chronic fissures look more old, likely have a deeper cut and may have internal fleshy growths. A fissure is also considered to be chronic if it persists for more than 8 weeks. Surgery is almost always necessary in case of a chronic fissure.

After a thorough diagnosis, your proctologist can easily tell the difference between the two and recommend a suitable surgery for you.

Why is anal fissure surgery required?

While acute anal fissures can heal on their own, the chances of recurrence in such cases are very high. For example, if a fissure is caused by constipation, the fissure may reoccur if constipation remains untreated. Your doctor may recommend some non-surgical treatments for your fissure but if the condition persists for more than 8 weeks, in which case the fissure is considered chronic, surgery is almost always necessary.

If you suffer from a fissure that has persisted for more than 8 weeks, it is recommended to contact your healthcare provider for a thorough diagnosis and treatment. Delaying the surgery or allowing a fissure to persist can cause the fissure to worsen over time and lead to serious complications. The fissure may even extend and start affecting the sphincter muscles in which case surgery becomes more complicated.

Preoperative tests and diagnostics

  • Tests and diagnostics: Before surgery, your doctor will likely ask about your medical history and perform some general tests and diagnostics including a gentle inspection of the anal region. Most anal fissures are visible and once they’re located, do not require further diagnostics but if your doctor suspects an underlying condition such as Crohn’s disease or ulcerative colitis to be the reason behind your fissure, he or she may recommend additional imaging tests such as:
  • Anoscopy: Anoscopy is a procedure that uses a tubular device called an anoscope to view the lining of your anus and rectum.
  • Flexible sigmoidoscopy: For this test, your doctor will insert a thin and flexible tube, that has a tiny camera attached to it, inside your rectum. This provides the surgeon with a detailed view of the lining in your anus and rectum.
  • Colonoscopy: This procedure involves inserting a thin, flexible tube into your rectum to inspect the entire colon.
  • Food and medications: Your doctor may instruct you not to eat or drink anything for the last 12 hours before surgery. If you take any blood thinning medications, your doctor may also advise you to temporarily stop taking them to reduce the chances of excessive bleeding during surgery as much as possible.

Procedure day

Sphincterotomy procedures do not require any special pre-operative procedures such as bowel prep. The field is typically prepared using a local antiseptic solution and does not require any intravenous antibiotics. A sphincterotomy is generally performed under local anaesthesia but depending on your overall health, your surgeon may prefer using general anaesthesia. Take your normal medications as usual unless you are directed otherwise by your doctor.

Methods of anal fissure surgery

There are primarily 2 ways to treat an anal fissure:

  • Lateral Internal Sphincterotomy: Often referred to as LIS or open surgery, lateral internal sphincterotomy is one of the most common methods of anal fissure treatment. This method is often preferred by surgeons to treat both an acute and chronic fissure but being an open surgery, it has its own set of potential complications. In a LIS procedure, the surgeon makes a small incision in the internal anal sphincter. The aim here is to reduce the tension on the sphincter as when the tension is too high, fissures are unable to heal. Once the incision has been made, and the anal muscles are allowed to relax, the fissure can heal on its own. An LIS procedure can be performed under local or general anaesthesia and is generally performed on an outpatient basis meaning, you can go home on the same day of the surgery.
  • Laser sphincterotomy: Laser sphincterotomy or laser treatment for anal fissure is often the preferred method of surgery by doctors when the patient suffers from a chronic fissure. In a laser sphincterotomy, a laser probe is used to emit infrared radiation at the site of the fissure and make a small incision similar to the one made in LIS. This incision allows the tight sphincter muscles to relax and reduce some tension. Once the tension is reduced, the fissure can heal on its own. The high-energy laser beam also increases the blood flow to the affected area and promotes faster healing of the fissure as compared to open surgery. Laser sphincterotomy is a minimally invasive procedure and the chances of fissure recurrence after laser surgery are significantly low as well. The procedure is generally performed under local anaesthesia but your surgeon may use general anaesthesia meaning you won't be awake during the procedure.

Post-operative care and recovery

The healing capacity of every person is different and hence, the recovery rate after your anal fissure surgery may vary. In most cases, a complete recovery takes about 1-3 months. Most people can return to work and continue their normal routine after 1-2 weeks of surgery. To promote faster recovery and reduce the chances of any complications, your doctor may recommend some temporary changes in your daily lifestyle such as:

  • Taking adequate rest and plentiful sleep to help boost your recovery.
  • Spicy or oily foods are to be avoided for some time. Fibre-rich foods such as watermelon, bananas, brown rice or cauliflower reduce the chances of constipation and help in softening up the stools.
  • Alongside a fibre-rich diet, about 2-3 litres of water is also needed to keep the stools soft and avoid constipation.
  • Perform a sitz bath 2-3 times a day for at least the first couple months after surgery.
  • Performing simple and easy exercises daily for at least 20-30 minutes. A sedentary lifestyle can lead to straining during bowel movements and cause the fissure to reoccur.

Risks and complications

Complications of any kind after an anal fissure surgery are very rare but as is the case with any other surgery, they can still happen. Some of the most common complications that occur after a fissure surgery are given below:

  • Bowel incontinence: Bowel incontinence is one of the most common complications that occur after an anal fissure surgery. During the surgery, sphincter muscles that are responsible for controlling bowel movement may get damaged and as a result, you may lose some control over your bowel.
  • Bleeding: Although very uncommon, there is a slight chance that heavy bleeding or haemorrhage could occur during an anal fissure surgery. If unexpected heavy bleeding occurs, your doctor may need to perform additional procedures to control it.
  • Failure of the fissure to heal: Even after a sphincterotomy procedure, the fissure may not respond well and in such cases should be re-examined. Conditions such as constipation or persistent large and hard stool can also cause the healing process to be slow or absent.
  • Fissure recurrence: Chances of recurrence in the case of an anal fissure are generally high if conditions like constipation or persistent diarrhoea were the reason behind your fissure and remain untreated.
  • Infection: While rare, infections after your fissure surgery can occur. If you exhibit symptoms such as fever, chills or pain that continues to grow after bowel movement, it is best to contact your doctor as soon as possible.

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