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7/21/2019 Fissure Surgery

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What is an Anal Fissure?

An anal fssure is a small tear, crack, or ulcer that develops in the skin around the

lining or passage o the anus. While the tears are usually small in nature, they tend to bevery distressing and discomorting to the suerer and can be very painul as well. However,

anal fssures can be treated and mitigated accordingly.

The pain tends to worsen when you pass stool and can persist or up to two hours or

so ater the passage o eces. Anal fssures occur in both adults and children along with

people rom both sees. !n some individuals, the fssure can heal ater two weeks, but some

can take even longer. !n act, some individuals suer rom chronic anal fssures in which the

condition can last or a period o up to si weeks without notable signs o disappearing.

"auses o Anal #issures

$ome o the actors that can cause or increase the probability o suering rom anal

fssures include%

& 'ld age( older individuals tend to be susceptible to the condition primarily because o

reduced circulation resulting in decreased )ow o blood in the anal canal.

& "onstipation( stressul and painul bowel movements in the gut, especially when

passing hard stools, can cause tears in the rectal area.

& "hildbirth( childbirth can be very strenuous to the anal canal, thus causing tears and

irritation that may result in anal fssures.

& "rohn*s disease( this is a chronic in)ammatory bowel disease that aects the lining o

the digestive tract that may make layers in the rectal area more liable to tearing.

+iagnosis

Anal fssures can usually be diagnosed by assessing the signs and symptoms that appear in

the suerer. #urthermore, medical practitioners usually implement coherent methodologies

that can be used to diagnose the condition. These methodologies may include internal

sphincterotomy, colonoscopy, or a fssurectomy.


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$ymptoms o Anal #issures

. -ain( since the anal canal has an abundance o nerves, it tends to be sensitive to pain

and the patient might eperience sharp pain when passing and ater passing o stool.

#ear o more pain can cause suerers to avoid visiting the toilet, thus making them

liable to constipation.

. /lood( this usually appears as bright red spots or patches on the stool or toilet paper.

/lood is generally considered one o the prime signs o anal fssures.

0. !tching( the itching sensation can be very discomorting and can lead to urther

irritation.

Treatment

! the condition does not resolve within a ew weeks, then a doctor might prescribe

some medication to help alleviate the discomort and pain. ! the patient suers rom

constipation, a laative might also be prescribed. The patient is also advised to increase

their dietary fber intake and drink plenty o water. $ome o the prevalent treatment

methodologies include%

& $teroid creams( these are useul in relieving discomort and irritation.

& /lood pressure medications( these can help rela the anal sphincter

& 1itroglycerin( i applied as a topical treatment on the body, this will help enhance the

)ow o blood, encourage healing and also relaing the anal sphincter.

& $urgery( this is considered an advanced treatment and is used or individuals who

suer rom chronic anal fssures.

"onclusion

!t is essential or people have su2cient knowledge in the treatment and detection o

anal fssures in order to catch them early and save the patient rom a lot o pain. #or a

deeper understanding o anal fssures and their treatment options, please consult the

riendly epert colorectal surgeons at the #issure 3 #istula "enter o 4cellence in 5os

Angeles.


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Anal Fissure Treatment

Anal fissures are defined as a tear in the lining of the anus, particularly where the

feces are excreted. The tear usually extends toward a circular ring of muscle called theinternal anal sphincter. Anal fissures are considered severe when they last for less than

six weeks; they become chronic when it goes beyond six weeks. A person

experiencing an anal fissure will initially experience bleeding, tearing, ripping, or a

burning sensation after bowel movements. When a fissure develops, these symptoms

regularly occur after every bowel movement, and the rectal pain can last several

minutes to an hour. When the fissure becomes persistent, the bleeding will stop but

the pain will continue to persist. Itching and irritation of skin around the anus are also

common symptoms of an anal fissure.

Anal fissure treatment methods relieve pain and spasms experienced during the

duration of the ailment; they also aim to heal the fissure. Initial anal fissure treatments

aim to soften stool, eliminate constipation, and minimize anal sphincter spasms.

Anal fissure treatment methods

Fiber treatment is a method of treating anal fissures that bars over-distension of the anal

region. This can be done by increasing fiber in the diet, which will lead to the

softening and bulking of the stool. Regular intake of fruits and vegetables will help

because these foods are rich in fiber. It is best if you eat 20 to 35 grams per day.

Another type of treatment is Sitz baths. These involve immersing the rectal area in

warm water for about 10 to 15 minutes two or three times each day. Sitz baths can be

bought in leading drugstores; there are even portable bowls that can be used for thosewho go to work and school. This sort of anal fissure treatment improves blood flow

and relaxes the internal rectal sphincter.


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Topical nitroglycerin is an ointment applied around the anal opening two to three times

daily plus before and after bowel movements. Nitroglycerin functions as a treatment

for anal fissures by increasing the flow of blood to injured tissues. It also eases pain

and further promotes healing by lowering pressure in the internal anal sphincter.

Surgery is a treatment method that should come as your last resort when all other

methods have failed to work. Lateral internal sphincterotomy is lauded as among the

most successful surgical methods. In this method, surgeons make a small incision in

the interior of the anal sphincter. This is essential in lowering the pressure, thus easing

the pain. The fissures then cure themselves, so there is no need to close them

surgically.

Surgical methods come with minor side effects such as incontinence. However, these

side effects fade away after a short period of time. The benefits of this method far

outweigh their drawbacks.

Anal fissure treatments also include Diltiazem, Nifedipine, and Botulinum toxin.

Nevertheless, it is best if you consult your healthcare provider. He or she is always the

best source of information concerning anal fissures. No two patients are exactly alike,and recommendations may vary from one person to another; it is best that you always

seek guidance from someone who is familiar with your individual situation.

Anal Fistula: Causes, Symptoms, and Treatments

An abnormal connection of one part of the body to another is called a fistula. When

such linkage occurs in the anus it is called an anal fistula. This is a connectionbetween the interior anal canal and the skin towards the outside of the anus. There are

many kinds of anal fistulae and they may occur for a variety of reasons like infection,

abscess, pus, or other disease. They are commonly seen in patients suffering from

inflammatory bowel diseases.


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The fistula treatment recommended by a specialist will depend on the type & extent of

fistula you are suffering from. Most fistulae need surgery because they will not heal

on their own. Your fistula surgeon will recommend surgery based on the type and

severity of your fistula.

Fistulotomy is the most commonly used surgical procedure, since it is highly effective

in curing high fistulae. In this methodology, the fistula track is completely taken out

by using an advanced radio-frequency device that works under a strong light source.

Fistulotomy helps fistula to heal from the inside out. However, dressing is essential

till the entire fistula heals completely.

Regular indications of an anal fistula would be agony, delicacy, swelling, and

aggravation in the anal area. Tingling may also be experienced. The disease might

likewise bring about slight fever, tiredness, and chills. One may not have much of anappetite and may feel uncomfortable.

Anal fistulas do not normally heal on their own; medicine or surgery will be

necessary. If medicine does not work, surgery will need to be performed. Surgery for

anal fistulae in the lower end of the digestive tract is called fistulotomy.

The technique is basic. The surgeon first makes an incision at the entry point of the

fistula channel to expose then clean the infected tissue. The treated area is then

sutured closed and laid flat. If any residual bleeding occurs, an antibiotic treatment

can be applied to the area. Typically, fistulas mend quickly with little bleeding, but

proper wound care is recommended to avoid any complications.

The technique is for the most part done under local anesthesia, while the fistula is

fairly small. On the other hand, if a larger fistula has formed, it may demand a more

complex or invasive surgical procedure.

For example, when the fistula is moderately severe, a Seton may be utilized. A Seton

is a kind of suture material which is utilized to tie off the fistula. The tie holds the

fistula in place, which allows it to heal. Fibrin paste may also be utilized to seal ananal fistual. In severe cases, the Endorectal Advancement Flap technique may be

utilized. Here, a piece of the rectal divide is taken and a fold is made which is then

used to cover the interior opening. With this technique, a medical device called an

Anal Fistula Plug can be utilized. This is a funnel shaped unit made up of cutting edge

tissue which helps spur further healthy tissue growth in the fistula.


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Although anal fistulas are painful and uncomfortable, there are a variety of ways that

they can be treated. Visit your anal fistula specialist at the Fissure and Fistula Center

of Excellence to learn more.

Choosing the Best Fistulectomy in Los Angeles

For you to get the best fistulectomy services in Los Angeles, you should always

ensure you have hired the right surgeon for the services. Fistulas can lead to

experiencing a lot of social problems, pain during bowel movements, and other

discomforts. In some cases it can lead to suffering from fecal or urine incontinence.

Anal fistulas should be diagnosed and treated quickly in order to minimize discomfort

and prevent worsening of the condition. However, not all surgeons who offer

treatments will handle your case with the great care that you deserve. You should take

your time and look for the best surgeons who will address the problem the right way.

There are many surgeons available, so you should take your time and look for onewho has a good reputation for offering the best services. Here are some tips for you to

locate the best surgeon possible:

Experience

In order to get the best care, you should make sure to hire a surgeon with a good

reputation who has experience in the procedure. Check the number of years they have

been practicing as well as patient testimonials. Its also good to make sure they have

experience with patients of your particular gender and age.

Cost of the fistulectomy in Los Angeles surgery services

Choose a surgeon who charges a reasonable rate for their services, and who will work

with you so that you can afford treatment. There is no need for you to spend lot of

your money on surgeons who will exploit you. The best surgeon for you to hire should

be ready to treat you at fair rates. Often, surgeons will accept health insurance; ask if

they accept yours and if so, how much of the procedures cost you will be responsible

for. However, price should not be the main factor in choosing a surgeon.

Read reviews about the surgeons before you decide to hire them

In order to get a feel for the surgeons level of expertise and bedside manner, you

should ensure you check on what other people are saying about the surgeons. The best

surgeon whom you should hire should have good reviews in offering the best services.


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The condition of the facility where the surgeons work also matters. The best surgeon

whom you should hire should operate in a facility where they will be able to offer you

the best services. A facility that has been fully equipped with equipment that employs

the latest technology is best. You can ask other patients who have been treated for

fistulas in the facility in order to get to know more about the quality of services and

technology employed in the facility.

Anal Fissure Symptoms

An anal fissure is a small tear or cut in the skin lining the anus. Fissures are a common

condition of the anus and anal canal. They are responsible for 6 - 15% of visits to

colorectal surgeons. This condition affects men and women as well as children. Anal

fissures are usually not a cause for undue concern, as most heal without any medical

treatment. Unfortunately, they do not always heal on their own, and in some cases are

severe enough to resist conservative treatments as well. In such cases, it is necessary

to seek the help of an expert colorectal surgeon. The following are anal fissure

symptoms:

Pain In The Anal Area

This is a common fissure symptom. This pain can sometimes be severe, especially

during bowel movements. This severe pain is usually caused by inflammation of the

anus and rectum. In certain cases the pain is so excruciating that it makes defecating a

problem. The worst part of all this is that this pain can last up to several hours.

Sentinel Pile

This is a tag of skin that may develop on the edge of the anus below the fissure. This

tag develops when the fissure is ignored or not treated quickly enough. This pile not

only makes it hard for you to pass stool but it also makes it difficult to wipe the anus

after visiting the toilet.


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Streaks of Blood On Stool Or On Tissue Paper After Wiping

After having a bowel movement, you may notice a streak of blood on the toilet paper

or on the stool. When the bowel passes on the torn area, it bruises the area and as such

blood from the wound is smeared on the stool. This causes a lot of pain and can be

very uncomfortable.

Burning Or Itching In The Anal Area

Sometimes, the patient may experience some itchiness around the anal area. This

might be mistaken for a reaction to a pinworm infection. However, this itchiness can

be very embarrassing, especially if it happens in a public place. Therefore, it is very

important to seek help from a professional as soon as possible.

A Visible Crack In The Skin Around The Anus

In extreme conditions, there may be a visible crack in the skin around the anus. This is

very dangerous, since stool passes through this area. This means that, it will take time

to heal because of the stool and the constant wiping of the area.

Causes Of Anal Fissures

Anal fissures can be caused by the following:

Chronic constipation

Diarrhea

Passing dry or hard stool

Inflammation of the rectum or the anus

Pregnancy

Scratching around the anus


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Crohns disease

Anal injury

Cancer of the rectum

Childbirth

To conclude, although there are several treatment options for anal fissures, it is

important to seek medical attention from a professional. Therefore, in case you

experience any of the above anal fissure symptoms, or you want to learn more about

anal fissures, please visit www.fissuresurgerymd.com for treatment options, advice

and specialized care on anal fissures. Alternatively, contact the expert colorectal

surgeons at the Fissure & Fistula Center of Excellence in Los Angeles.

What are the Proven Surgical Treatments for Anal Fistulas?

The anus is the external opening through which feces from the body are driven out.

There are a number of small glands just within the anus. If any of these glands is

blocked, this can be an abscess - an infected cavity. An anal abscess is usually treated

by surgical drainage, although some are spontaneously drained. Around 50% of

abscesses can become fistulas, in which a small tunnel connects the infected glandwith an opening in the skin around the anus, usually within one year.

Treatments for Anal Fistulas

Anal fistulas are often treated with a surgical operation done by a colon and rectum

specialist. During the surgery, the doctor will assess the depth and breadth of the

fistula tract. Most fistulas are treated using a fistulotomy, in which the skin and the

muscle above the tunnel are cut, turning it into an open groove. This will allow the

fistula tract to heal from the inside out. A more complex fistula may require a special

drainage device - a seton - for at least six weeks, after which a definitive surgical

repair is done. For fistula surgery done on an outpatient basis, the tunnels of a fistula

that are very large or deep may need a short stay at the hospital.


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What are the Surgical Treatments for Anal Fistulas?

These surgical treatments are intended to definitively eliminate the fistula and correct

abnormalities that have emerged as a result of the same, without compromising anal

continence. The disappearance of the fistula implies the disappearance of the

associated painful discomfort, inflammation or/and oozing.

Depending on the type of fistula, its path, depth, etc., different types of intervention

can be made.

Fistulotomy:

This procedure consists of the opening and emptying of the fistulas as well as

ensuring healing as efficiently and quickly as possible.

Fistulectomy:

This procedure involves complete excision of the fistula. The disadvantage with

respect to the fistulotomy technique is that it leads to larger wounds and, therefore,

healing is slow and expensive.

Line or seton:

There are three variants of this technique, depending on the overall objective of the

surgery.

Cutting Seton: the goal of this mode is the elimination of the fistula. This is done

through the same surgical silk that is tightened gradually for the silk section in the


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sphincter but at the same time have enough time to heal.

Drainage Seton: This is carried out to drain the pus or detritus of the fistula, which

will prevent the formation of a new abscess. Silk will be placed through the fistula,

and once completed, the process of drainage allows surgical repair in the absence of

infection.

Seton Guide: This is placed in the same way as the drainage seton. Its function is to

keep the fistula permeable until the patient can be operated on permanently.

If you suspect yourself to have a fistula, there can be no better place to get the needed

diagnosis than from professional doctors specialized in anal fissures. Why don't youvisit Los Angeles colorectal expert surgeons at the Fissure and Fistula Center of

Excellence, known for their intensive care on conditions affecting the anal area and

rectum, including anal fistulas?

Anal fissure surgery in Los Angeles - The Basics

The initial treatment for anal fissures begins with topical and oral medications. It is

only when these medications fail to work that fissure surgery comes into place. The

basic treatments involve the use of calcium channel blockers and glyceryl trinitrate

that is suggested by a healthcare provider. Sometimes, even mild laxatives are

suggested to make stool soft and decrease straining and pressure.

Before going for anal fissure surgery, you should read some articles on fissure surgery

methodology to verify that you have satisfactory information. Fissure surgery is the

final resort for treatment, and should only be considered when more conservative

treatments fail to work.

Preparing for a fissure surgery in Los Angeles

Your surgeon will explain the fissure surgery process as well as any special steps orrequirements to be met beforehand. There are certain restrictions to be followed

before surgery; for example, you can't smoke. Smoking increases the danger of

developing infection in the midsection, which will slow recuperation post surgery.

Therefore, it is essential to control certain variables.

Prior to the operation, you have to have a totally solid discharge. So as to accomplish


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this, you may be given a specific diet to follow for two or three days, and purgatives

too before the day of surgery.

Fissure surgery in Los Angeles is performed in a single day. Once the surgery is done,

you can go right home, although you will need to follow post-surgery guidelines.

The Procedure

The surgery can be done under general anesthesia, so you will be sleeping during the

surgery. However, local anesthesia can often be used instead. Local anesthesia numbs

the area to be treated so that you will not feel any pain or discomfort, but will still be

awake. The benefit of local anesthesia is that recovery time is quicker immediately

following the procedure, and you can avoid potential side effects of general

anesthesia.

Your doctor will determine which type of anesthesia is best based on your individual

condition and constitution.

The surgery for anal fissures is known as anus sphincterotomy, which involves

making a cut in the anus sphincter muscles. This will allow you to strain less than

normal when you go to the restroom, and this in turn will put less pressure on the

fissures, accordingly giving you more opportunity to recuperate.

The incision is made into the sphincter muscles using a razor sharp edge. At thatpoint, a dressing cushion is placed into the anus in order to stop any bleeding.

Post Surgery

Post fissure surgery, it takes almost no time to recuperate. Then again, you may need

to rest for quite a while until the analgesic state has passed. You may need pain

relievers as well. Most patients are free to leave soon after the surgery; however, some

may need to stay overnight.

Botox for Anal Fissures - Treat Fissures Without Causing Harm

An anal fissure is a tear in the skin around the opening of the anus (the last part of the

digestive tract that controls the removal of stool). An anal fissure is associated with


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pain and bleeding during bowel movements. The condition is more common in young

infants but it can happen at any age. Anal fissures are usually caused by trauma or

injury to the anal canal while passing hard or large stools, constipation, diarrhea or

childbirth.

The average symptoms of an anal fissure include pain during and a few hours after

solid discharge. Despite the fact that the tear created by an anal fissure is small

(around 1cm), the condition is painful and may endure for an hour or more in the

wake of defecation. The extreme pain may make patients worried to the point of

avoiding defecating, which further exacerbates the condition. Pain is normally more

intense in more severe anal fissures. Different side effects include:

Blood in stool, on toilet paper, or in the toilet bowl

Broken or torn anal skin

Bothersome fissures

Yellow release that has an offensive smell

Chronic anal fissures can become deeper and form ulcers, which can further slow the

healing process.

Most anal fissures can be analyzed by a physical examination which involves viewingthe anal area and reviewing your therapeutic history. At times, diagnosis is finished by

a computerized rectal examination or by using an instrument called an anoscope. The

anoscope is a short instrument with a lit tube which can help the specialist see and

examine the fissure.

Anal fissures normally heal on their own in a couple of days or weeks (acute),

however, in situations where it doesn't mend even following 6 weeks (chronic),

restorative treatment or surgery is suggested.

Botox for anal fissures more often than not involves adopting straightforward

measures to keep your stool manageable; for example, by increasing fiber and liquid

intake. Soaking in warm water for 10 - 20 minutes as frequently as possible,

especially after defecation, additionally assists with healing and reducing discomfort.

In the event that symptoms still continue, further treatment may be necessary, which

involves using steroid creams and Botox injections. Topical soporifics and pain


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solutions might likewise be recommended to control pain.

Surgery is prescribed if symptoms don't react to conservative treatments. Surgical

treatments include:

Horizontal internal sphincterotomy

Fissurectomy, which involves surgically removing the anal fissure and leaving an

open injury to recuperate

Anal grafts, which involve replacing broken tissue with solid tissue from elsewhere

on the body

Horizontal sphincterotomy is the most widely recognized surgical method indicated

for the treatment of anal fissures. The surgery is typically performed under localanesthesia in an outpatient setting, where you can go home the same day as the

surgery. The surgery involves making a small cut or incision in the sphincter muscle

to decrease the strain in your anal canal, which permits the anal fissure to recuperate.

The incision can be closed or left open to recuperate.

After the surgery you will be given some painkillers. Remember to remove the

dressing before any solid waste discharge. Complete recuperation from anal fissure

surgery may take a while; however, this changes between individuals.

Likewise, as with any surgery, anal fissure surgery involves certain risks, for example,

danger of infection and anal incontinence, which includes the inability to control gas

and loss of strong stool.

Anal Fissures: Lateral Internal Sphincterotomy

Surgery may be needed if medicine fails to heal a tear (fissure) in the anus. The

preferred procedure is lateral internal sphincterectomy. A doctor makes a small

incision in the internal anal sphincter, one of two muscles that control the anus. This

can be done as outpatient surgery under local anesthesia or general anesthesia. Theinternal anal sphincter is constantly under strain, otherwise called resting weight. On

the off chance that that weight turns out to be too high, a fissure may form or an

existing one may not heal on its own. An incision diminishes the resting weight,

allowing the fissure to mend.

It's imperative to understand that, even with surgery, an anal fissure must mend all


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alone. A sphincterotomy involves operating on the sphincter muscles, not closing the

actual fissure.

Lateral internal sphincterectomy has a superior success rate than any medicine that is

utilized to treat chronic anal fissures. The outcomes last longer, and fewer individuals

have recurrent anal fissures than after treatment with medicine alone.

An anal fissure can bring about a considerable measure of pain, regularly resulting in

stoppage as patients become hesitant to pass stool. Bleeding is commonly seen on

bathroom tissue after defecation, and the blood is deep red. Numerous anal fissures

are thought to be brought about by passing hard stool, and frequently they will heal

independent from outside treatment. In individuals where the fissure does not heal on

its own, it is believed that an anomaly of the internal anal sphincter may be available,

which decreases the measure of blood flowing to the fissure. The sphincter muscle

weight is regularly too high, and lateral internal sphincterectomy can bring down theweight to an ordinary level.

For most patients, restorative anal fissure treatment is effective by using measures

such as stool softener and high-fiber diets. It is when such medications come up short

that patients may experience a lateral internal sphincterotomy methodology. Surgery

can be done under general anesthesia, where the patient is fully unconscious, or local

anesthesia, where the area treated is numbed but the patient is still conscious.

The specialist utilizes a surgical tool to make a cut in the round internal anal sphinctermuscle. It is critical not to harm the outside anal sphincter muscle which encompasses

it. The surgery takes around 15 minutes to perform and patients can ordinarily return

home that day. A great many people make a full recuperation and find that their anal

fissure pain diminishes rapidly.

Lateral internal sphincterectomy difficulties are uncommon. However, some risks

may include infection, pain and bleeding. Now and then patients are left with a level

of incontinence, which may involve passing defecation together with gas, or a small

measure of involuntary soiling. Most often, these issues come up immediately after

surgery but resolve later. In some patients, the anal fissure does not mend following

lateral internal sphincterotomy, or the fissure repeats. Around half of situations where

the fissure does not heal completely are connected with an inflammatory condition

known as Crohn's disease.

In the event that you are deciding whether to have this surgery, it is critical that you


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consider the possibility of incontinence. In some cases, the danger of incontinence is

high enough that lateral internal sphincterotomy should not be considered. This may

be the case for women who develop an anal fissure during childbirth, in light of the

fact that they regularly don't have a high resting weight in their internal sphincter. A

methodology called anal progression fold may be done instead of sphincterotomy. In

this system, the edges of the fissure are evacuated, and sound tissue is sewn over the

zone.

What is a Fistulotomy? - Fistulotomy in Los Angeles Explained

A fistula is an abnormal connection or passageway formed between the end of the

bowel and the skin near the anus. An anal fistula is the channel formed between the

anus and perianal skin, causing bleeding and discharge while passing stool as well as

pain. Fistulas can either develop spontaneously or secondarily to perianal or perirectal

abscess drainage after a surgery. A fistula has two openings an internal opening inthe rectum or anus and an eternal opening in the buttocks.

Fistulotomy in Los Angeles Overview

An anal fistula can be an abnormal channel as well as tunnel-like lesion that starts in

the anus and ends outside around the skin of your hindquarters. Its development is

usually the result of a previous anal infection or abscess. About 50 percent of men and

women with an anal abscess have a fistula.

Diagnosis of Anal Fistula

Usually, a simple clinical evaluation is sufficient to diagnose the occurrence of a

fistula, which involves a proctoscopy. However, in some cases, a fistula doctor may

suggest an MRI Fistulogram.

Fistula Treatment

Surgery is probably the main treatment alternative to cure an anal fistula. Antibiotic

medication can certainly control the infection, yet the key danger of recurrence always

persists. In some cases of fistulas, persistent drainage is observed, whereas in other

cases, the outside opening of the channel closes and the major danger is a recurrent

abscess. The type of surgery depends on the size and location of the fistula.

DISADVANTAGES


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Pain-This surgery leads to a large channel from the anal opening to the cheek.

Understandably this leaves the patient with some pain in the post operative period.

Invasive-The procedure involves incisions which may scar.

Long Hospitalization-The patient generally needs hospitalization for 4-8 days or even

longer.

Long recovery time - The patient requires dressings for 4-6 weeks and should not go

to work during this time.

High recurrence rates-. In spite of all these difficulties, this surgery is associated with

a high recurrence rate.

Danger of Incontinence-The procedure has a definite danger of incontinence,

especially in high fistulas.

Surgical Treatment of Fistula

Fistulotomy

Recent statistics demonstrate that 85-95% of fistula patients undergo fistulotomy.

In this procedure, a small divide of the anal sphincter is sliced in order to open the

fistula tunnel.The inner contents of fistula are flushed out, which heals after a month

or two and resembles a flattened scar.

Surgery for anorectal fistulae is well on the way to cause certain side effects, for

example, recurrence, infection, and incontinence; however, some patients may not

experience any side effects. The most important thing to note in case of fistula

treatment is that one ought to never go further without proper diagnosis, professional

expertise, and authentic treatment.

A great deal of research is going on worldwide to discover more treatment alternatives

for fistulas which can be less painful, less expensive, and with fewer side effects.

There are two kinds of surgery which are the oldest and the best studied of all the

methods. In a fistulotomy, the fistula tract is laid open by cutting out the whole tract


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with knife. In a fistulectomy, the fistula tract is totally taken out. The resultant injury

is generally not closed and left open to heal on its own. Along these lines the chances

of recurrence are decreased.

Following a fistulotomy in Los Angeles, topical antibiotics in addition to dressings are

used to prevent bleeding and infection. The patient is conveyed to a recovery room till

the anesthesia wears away. They are then usually prescribed antibiotics in addition to

painkillers and presented with instructions about tending to surgical injuries at home.

Some discomfort with sitting and bowel movements may occur for around a month of

recovery. A follow-up appointment with your doctor can affirm the process was

successful and that healing is taking place.

Are there Any Topical Treatments for Anal Fissures?

A lot of different factors can lead to the development of fissures in the anal liningamong men and women of all walks of life. Although not considered serious initially,

the condition may worsen when not treated at the earliest possible time. Anal fissures

brought about by pregnancy and other acute causes are not necessarily treated with

surgery, but if you are experiencing severe symptoms such as painful bowel

movements that last for hours or frequent appearance of blood in your stool, surgical

intervention by colorectal surgeons at the Fissure & Fistula Center of Excellence in

Los Angeles may be required.

Topical Treatment for Anal Fissures

In mild cases of anal fissures, non-surgical treatments are often indicated. Topical

treatment for anal fissures is primarily aimed at not only promoting the healing

process but also at relieving physical symptoms. To avail yourself of the best topical

treatment specific to your case, consulting a colorectal surgeon in Los Angeles is a

very good decision.

Both acute and chronic anal fissures are treated with topical treatments. Some of themost common topical treatment options include the following:

1. Calcium channel blockers

Calcium channel blockers help relieve symptoms and promote healing in cases of anal

fissures by reducing pressure in the area. Although associated with certain side


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effects, these medications, when used according to your doctors instructions, are

generally safe and effective. Calcium channel blockers come in gel form. The

medication is applied in the area four times a day or as prescribed by your physician.

2. Nitroglycerine cream

Nitroglycerine cream is another medication usually prescribed for healing chronic

anal fissures. With its many side effects, however, application of the cream in the

fissures must be made with utmost care. Nitroglycerine works by reducing pressure in

the anal sphincter muscle.

How Botox Helps Treat the Condition

In cases unresponsive to topical treatments, colorectal surgeons in Los Angeles

usually recommend Botox treatment. Though commonly known as a cosmetic surgery

procedure, Botox has become a breakthrough treatment for anal fissures over the

years. Botox helps promote healing of anal fissures by paralyzing the anal sphincter

muscle, thus promoting relaxation.

The treatment is usually conducted within the clinic and lasts for a few minutes to

hours. Most patients are usually allowed to go home immediately after a Botox

injection.

Treatment Considerations

It is very important for you to finish the topical treatment regimen to complete the

healing. Some patients stop treatment after symptoms begin to cease, but completing

the treatment is essential to prevent relapse of symptoms. A follow-up appointment

after the treatment is also necessary to determine whether you are completely healed

or if you need further medication.

Other important tips for faster treatment include the following:

-Avoid straining bowel movements.

-Increase fiber intake.


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-Increase oral fluid intake.

-Exercise regularly to promote peristalsis.

Conclusion

Anal fissures are non-serious conditions that can bring about painful or uncomfortable

symptoms. To know more about anal fissures, its causes, symptoms and treatments,

contact your trusted colorectal surgeons at the Fissure & Fistula Center of Excellence

in Los Angeles or visit their official website at www.fissuresurgerymd.com.

All you need to know about fistula surgery in Los Angeles

A fistula is a disease which people think cannot be cured fully or involves a lot of

pain. To come out of this misconception we first need to understand what a fistula is,

how it occurs, and what its symptoms are. A fistula is an abnormal passage between a

hollow or tubular organ and the bodys surface, or between two hollow or tubular

organs. There are two types of fistula: one is called a high fistula & the other is a lowfistula. There are many causes which can lead to a fistula, such as those as follows:

1) Infection at anorectal abscess

2) Pus discharge

3) Unhygienic state of anal region

4) Trauma near anal region

5) Constipation

The symptoms of a fistula can include:

1) Discharge


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2) Pain at anal region

3) Boils near anal region

4) Recurring injury at anal region

5) Fever & chills

More often than not the skin appears red and inflamed in the area from which the

discharge and blood comes. Finding the fistula opening in the anus is very important

for treatment of fistula surgery in Los Angeles. A fistula diagnosis can be done by a

proctoscopy or MRI fistulogram. A fistula doctor then decides the course of treatment

once the reports have come. There are many treatments available for fistulas,

depending upon the severity. Some of the treatments for fistulas are as follows:

1. VAAFT-Also known as Video Assisted Anal Fistula Treatment. This is an

innovative technology for selected fistula cases.

2. Ksharsutra-This is a traditional ayurvedic therapy.

3. Fistulectomy-The fistula tract is completely removed using an advanced

radiofrequency device under a special light source.

4. FiLAC-This is Fistula Laser Closure. It's a procedure performed with the help ofthe Leonardo Laser Device that gently and effectively cures the anal fistula and also

prevents damage to the sphincter.

The surgery to take care of a fistula is conducted under local anesthesia and takes

around thirty minutes unless there are other complications. The most essential danger

involved could be the elasticity of the sphincter muscles inside the anus. These

sphincter muscles would be the tissues that assist in contractions as well as relaxation

throughout the anus so that bowel movement may be possible. Once the tract is

identified, the surgeons for VAAFT treatment ensure that the complete tract is

cleansed and then the opening is closed. The tracts are left open so that secretions in

the post operative stage can easily find a way out. The doctors then monitor the

patient and check the progress. In the vast majority of the cases of open fistula

surgery, the tracts do not heal as the tissues have the tendency to form a collagen layer

over them that hinders healing process. However, through the VAAFT technique there

is no such problem, as there is less chance of infection through a large incision; rather


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a scope is used and the puncture is quite small. This also improves the healing time.

Along with aforementioned benefits, when this process is conducted by the best

VAAFT surgeon then the operative time reduces by more than half.

Following the fistula surgery in Los Angeles, recurrence of the anal fistula may be

possible. Slight bleeding, pain and uneasiness may be experienced not long after this

process until there is complete recovery, which can take a month. Not long after the

process, a normal eating plan as well as other activities can be carried out.

The Best Treatment for Anal Fissure in Los Angeles

Anal fissure is a common problem found amongst all ages and all sexes. It is basically

a disease caused by constipation. It is a cut or the tear in the lining of the anal canalwhich causes severe pain while defecating. It normally lasts for 6 weeks or less;

however, if it continues for longer than that, it is considered chronic and is a more

severe problem.

At times along with the pain the patient even starts bleeding. Then the situation

becomes very dangerous, which should not be ignored. Immediate treatment for this is

always advisable.

Many patients have been successfully treated for anal fissures in Los Angeles at the

Fissure and Fistula Center of Excellence.

What Causes Anal Fissures?

Anal fissure is mainly caused due to the following reasons:-

1) When an excessively large stool is passed.

2) When there is extreme pressure on the anus when passing bowel movements

3) With repeated diarrhea

Anal fissures are also common for women after childbirth. There could be some other

minor reasons as well like anal intercourse, rectal exams, or application of any foreign

object in the anus. At times they can be caused by Crohns Disease.

Major Symptoms Of Anal Fissures


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Acute pains in the anus during bowel movements associated with rectum bleeding are

the two main signs of this disease. And if the pain is too severe then it produces a

burning sensation for more than 2-3 hours.

What Could Restrict The Occurrence Of Anal Fissures

Anal Fissures mainly occur due to constipation, so if this is cured then the chance of

getting this particular disease is minimized. For that, more fibers should be taken in

the diet along with sufficient fluids. Also some stretching exercises could be very

helpful. All these should be done to regularize the bowel movement.

Treatment of Anal Fissures

Fissure treatment in Los Angeles- As mentioned above, the treatment of this disease

has been quite successful in Los Angeles, specifically in the La Peer Fissure & FistulaCenter of Excellence. Here the patient is treated in both surgical and non surgical

ways. The best treatment plan for the individual patient is decided based on a number

of factors, including the severity of the fissure. For example, if the doctor feels that

the cut is minor, then normal non surgical treatment is initially applied, such as a Sitz

bath, zinc oxide cream, etc. However, if it is found that the wound is too deep, then

the doctor may recommend surgery.

The technology used for this treatment is the latest and most advanced, and moreover,

special attention is given to heal the torn area as soon as possible. The facilities and

the medicines offered here are state of the art.

In fact, a recent innovative therapy has been introduced here which cures acute Anal

Fissures immediately. This treatment is Botox injections. These injections are applied

directly into the internal anal sphincter area. It is an effective and quick healing

procedure which does not require anesthesia.

To know more about the anal fissures and their treatment options, please refer to the

expert colorectal surgeons at the Fissure & Fistula Center of Excellence in Los

Angeles. Or you can visit their website at www.fissuresurgerymd.com


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Anal Fistulae An Overview

Over 200,000 people in the USA are diagnosed with anal fistula every year, making itone of the most commonly prevalent anorectal conditions. An anal fistula is an

abnormal, inflammatory passage that gets formed between the anal canal and the skin

adjacent to the anus.

Fistulae are caused due to the presence of an abscess in the anorectal area. When an

anal gland becomes infected, it can lead to development of an abscess. The abscess

may stay confined to the area of infection or may spread down to the perianal region,

resulting in the formation of a fistula. Almost 50% of the people who get anal fistula

go into developing chronic fistula that lasts for several weeks.

Anal Fistula Symptoms

An anal fistula is a painful condition that is characterized by throbbing, which

worsens when the patient sits down. The patient experiences swelling, scarring, and

redness of skin adjoining the anal orifice. Other symptoms include a discharge of

blood and abscess while passing stool. Constipation and pain associated with

difficulty in bowel movements are common indicators. The patient could possibly

develop a high fever, and should seek medical attention if it goes beyond 38 C

(100.4F). Since the body is unable to get rid of toxins as efficiently as it should, the

patient is bound to feel nauseous and constipated.

The diagnosis of anal fistulae is fairly simple. A digital rectal exam usually suffices to

identify an anal fistula. Digital exam refers to the process wherein the doctor inserts

their gloved finger into the rectum to detect any abnormalities on the walls of the

rectum. This is done with the help of a lubricant to minimize the discomfort for the

patient. In some cases, the colorectal specialist may need to conduct a thorough

clinical evaluation, consisting of ultrasound, MRI or CT scans. This is usually done to

diagnose associated conditions like rectal cancer, inflammatory bowel disease and

sexually transmitted infections.

Treatment for Fistulas in Los Angeles

There are 3 treatment plans available, depending on the type of fistula and the extent

of damage that it may have caused. Filling up the fistula with fibrin glue is a non-

surgical procedure. Though the initial success rate of 77% looks promising, it drops to


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14% after sixteen months. Up until now, surgery has been the only reliable technique

to repair the fistula.

The third treatment plan involves filling the fistula cavity with a bioprosthetic plug

and securing it with stitches to keep it in place. The bioprosthetic plug is also known

as fistula plug, in simple terms. The method promises a success rate of 80%. A team

of colorectal specialists in Los Angeles have been working on it to perfect the method

and help the patients of anal fistula. The fistula plug is a conical plug that is made

from human tissue, and uses the submucosa of the small intestine. Since the fistula

plug is a made from something as natural as a human tissue, it merges completely

with the patients tissue at the end of the healing process.

The fistula plug is a better option than full-blown fistula surgery and fibrin glue.

However, the procedure has its own risks. To discuss your prospects with this

treatment plan and the possible risks, you can get in touch with the colorectalsurgeons at the Fissure & Fistula Center of Excellence in Los Angeles.

To learn more, please visit www.fissuresurgerymd.com.

How is the LIFT Procedure Performed?

Anal fistulas do not have a specific cause, but there are ways to live a healthy life and

minimize risk of developing the condition. A patient with an anal fistula often sufferspain along with discomfort. If an anal fistula recurs or becomes chronic, it may

require surgery. In this unnatural condition, channels or connections are formed in

between the organ of body plus the anal region. Human body fluids and pus might

leave the body because of this anomaly.

An abnormal network of one section of the body to another is known as a fistula. In

the point when such linkage happens inside the anus it is known as an anal fistula.

This is a connection between the inside anal canal and the skin towards the outside the

anus. There are many varieties of anal fistulae, and they may happen for manydifferent reasons such as contaminants, abscess, discharge, or different diseases. They

are often found in patients suffering from inflammatory bowel diseases.

Basic symptoms of an anal fistula can be pain, delicacy, puffiness, and irritation inside

the anal area. Tingling is often experienced. The contamination can also cause slight

fever, tiredness, chills, as well as weakness. Patients may not have an appetite, and


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will feel discomfort.

The Actual Technique

LIFT, which stands for ligation of intersphincteric fistula tract,is a minimally invasivesurgical procedure which does not require the sphincter muscles to be cut. This procedure

involves securely closing the internal opening of the fistula and removing infected

cryptoglandular tissue. .

This LIFT procedure starts off by making an incision in the fistula opening in the anal

canal to find where it is in the intersphincteric tract, the spot involving the sphincter

muscle groups. Another incision is made in the external opening of the fistula, and a

tube is placed through the fistula in order to identify the tract and clean the area.

Infected tissue is removed. Then, both openings are closed in order to prevent both

infection and recurrence of the fistula.

A seton can also be used to widen the fistula to facilitate removal of infected tissue. A

few weeks later, your doctor will remove said infected tissue and close off the fistula

openings, which allows them to collapse and heal.

The system is normally carried out under local anesthesia, if the fistula is not too

large. However, sometimes fistulas may require more complex surgery in which

general anesthesia may be needed.

A seton may be necessary in the case of abnormally large fistulas. A Seton is a type of

suture material that is utilized to wrap the abnormal pathway. A circle can be formed

which prevents movement, which aids in healing. Alternatively, fibrin paste can be

utilized to create coagulation inside the tract to close it off. In a complicated

condition, the Endorectal Improvement Flap system could possibly be utilized. Here,

part of the rectal wall is analyzed and a flap is created to cover the interior opening.

With this system, a medical item known as an Anal Fistula Plug may be used. This is

a conical unit made up of advanced tissue graft which often advances tissue

development inside the affected area.

To learn more, please visit www.fissuresurgerymd.com.

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