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<p><span style="color: #00826a;"><strong>Anal margin fissure is</strong></span> a wound caused by hardened stool that injures the sphincter muscle when trying to push it out. Anal margin fissure is a common condition that is often overlooked because it can easily occur and heal on its own. However, if left untreated for a long time and the wound does not heal, <span style="color: #00826a;"><strong>Dr. Theerasan Tantitemit, a colorectal surgeon at Phyathai 2 Hospital</strong></span> recommends seeing a doctor promptly to examine the symptoms and severity of the condition.</p>
<p>&nbsp;</p>
<h2 style="color: #008080;"><span style="color: #00826a;">What causes anal margin fissure?</span></h2>
<p>This wound is caused by stool injury. If the initial injury is not cared for and repeated injuries occur, it can lead to the disease! Normally, when a person strains to pass stool, the stool may injure the front and back of the anus causing wounds, especially in those with constipation where the stool is already hard, making injury more likely. Anal margin fissures can occur and heal within 1-2 days, but if left for weeks without healing, a doctor should be consulted.</p>
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<h2 style="color: #008080;"><span style="color: #00826a;">What causes the wound not to heal naturally?</span></h2>
<p>Normally, wounds in our body heal naturally, but the reason anal margin fissures do not heal may be due to physical characteristics. Our sphincter muscle is divided into inner and outer layers. The outer layer, which we contract, is thick and cylindrical. When wounds occur at the front and back of the anus, the sphincter contracts, restricting blood flow, which causes the wound not to heal.</p>
<p>&nbsp;</p>
<p>Normally, the sphincter muscle contracts automatically when stimulated by pain. The more painful it is, the less control we have over the sphincter muscle. When straining to pass stool, it becomes very painful and difficult because the inner sphincter does not relax.</p>
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<h2 style="color: #008080;"><span style="color: #00826a;">Symptoms of anal margin fissure</span></h2>
<ul>
<li>Fresh blood comes from the wound, but not in large amounts</li>
<li>Pain at the wound when straining to pass stool, making it difficult to pass stool, and pain persists for a long time after bowel movement before healing</li>
<li style="list-style-type: none;"></li>
</ul>
<h2 style="color: #008080;"><span style="color: #00826a;">Treatment methods for anal margin fissure</span></h2>
<p>Treatment for anal margin fissure is divided into two approaches: non-surgical treatment and surgery.</p>
<ul>
<li><span style="color: #00826a;"><strong>Non-surgical treatment</strong></span>
<ul>
<li>For patients who visit the doctor early, treatment involves taking medication to soften stool to aid bowel movements and reduce the need to strain</li>
<li>Use topical medication along with oral medication. This topical medication has a side effect of headache and is the same type used to dilate coronary arteries, which can help relax the sphincter</li>
<li>Botox injections cause temporary muscle paralysis. Some cases heal, some recur. Therefore, it is not commonly used in Thailand</li>
</ul>
</li>
<li><span style="color: #00826a;"><strong>Surgery</strong></span>
<ul>
<li>Surgery for anal margin fissure involves cutting the sphincter muscle to separate it, permanently widening the muscle at the site of contraction. Surgery is indicated when medication treatment fails to cure the condition</li>
</ul>
</li>
</ul>
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<h2 style="color: #008080;"><span style="color: #00826a;">Advantages of surgery</span></h2>
<ul>
<li>It is a treatment method with few side effects and minimal complications</li>
<li>No hospital stay is required, the wound is not painful, and patients can return to work the next day, but it requires a highly skilled doctor for accurate diagnosis and treatment</li>
<li>Surgery is performed under local anesthesia without the need for spinal block</li>
<li>It is a surgery without wounds, using a small blade similar to cataract surgery, making a single incision that heals immediately without the need to open or stitch the wound</li>
<li>After surgery, patients rarely have problems with incontinence, relieving concerns about stool control. There may be flatulence control issues in about 30% of cases, which improve within approximately 1 month
<ul>
<li style="list-style-type: none;"></li>
</ul>
</li>
</ul>
<h2 style="color: #008080;"><span style="color: #00826a;">Possible side effects of anal margin fissure</span></h2>
<ul>
<li>Most anal margin fissures do not get infected and heal on their own, but if not healed, inflammation may worsen</li>
<li>Long-standing wounds do not develop into cancer but can turn into perianal abscesses</li>
</ul>


Anal margin fissures often result from hard stool tearing the sphincter muscle during defecation. Normally, the wound heals easily. If the wound feels slow to heal or worsens, you should consult a doctor.

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Frequent constipation, hard stools, beware! Anal fissure disease

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