Publication:

Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients

Background Fissure-in-ano is a common yet troublesome condition; if acute, the severity of patient discomfort and extent of disability far exceed that would be expected from a seemingly trivial lesion. The present study was carried out to study the effectiveness of conservative management in symptom relief in acute fissure in ano.

Methods The study was conducted in 165 patients with acute fissure in ano attending Surgery OPD and/or admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa during the period from 1st August 2015 to 31st July 2016. It was a prospective clinical study. All the study subjects underwent extensive clinical examination and were prescribed conservative treatment regime. Follow up was done at the end of 2 weeks, 4 weeks and 6 weeks and the data was analyzed. 165 patients diagnosed as having acute fissure in ano. The outcome was assessed based on the following parameters; symptomatic relief, pain relief based on visual analogue scale and healing of ulcer.

Results Most of the patients were young adults with a slight female dominance. Pain during defecation and bleeding per rectum were the major presenting complaints. 73.94% of patients achieved symptom relief within 2 weeks of conservative treatment. At 6 weeks follow up after giving conservative line of management, 97.58% achieved symptom relief with healing of ulcer. Mean pain score was reduced from 9.5±0.71 at the start of therapy to 1.33±0.69 at the end of 6 weeks of conservative therapy.

Conclusions Acute fissure in ano can be easily cured with systematic usage of conservative treatment regime. A proper follow up along with patient education can help to achieve good remission and avoid unnecessary surgical intervention.