What is Chronic Anal Fissure? | Dr. Chung's Treatment.

Summary

In this informative video, Dr. Albert Chung, a proctologist, discusses the differences between acute and chronic anal fissures, focusing on their diagnosis and treatment. While acute fissures are recent and chronic ones last longer than six weeks, Dr. Chung emphasizes that treatment should be tailored to the individual. He advocates for non-surgical methods, sharing his success in healing fissures without resorting to surgery for the past five years. Dr. Chung offers personalized consultation and encourages viewers to understand the lifestyle factors that contribute to healing.

Takeaways

• 😀 Acute anal fissures are defined as those that have been present for up to six weeks, while chronic fissures last for six weeks or longer.
• 😀 Acute anal fissures look like fresh cuts, while chronic fissures may show healing tissue or overgrowth, and sometimes form a sentinel pile or skin tag.
• 😀 A chronic anal fissure diagnosis does not necessarily mean surgery is needed. Dr. Chung successfully treats all fissures without surgery.
• 😀 Patient history plays a key role in diagnosing the type of fissure. Doctors rely on how long the patient has been experiencing symptoms to make a diagnosis.
• 😀 Dr. Chung treats acute and chronic anal fissures the same way, emphasizing that the treatment approach does not change based on the classification.
• 😀 The healing of an anal fissure depends on individual factors such as lifestyle, diet, stress, and stool texture, not just the duration of the fissure.
• 😀 Dr. Chung believes that healing chronic anal fissures is possible, even after long periods of time, with the right approach and understanding of the condition.
• 😀 A holistic approach is essential for healing anal fissures, addressing not just the fissure itself, but also the overall lifestyle and health of the patient.
• 😀 While many treatments like creams and pain management can help, dietary adjustments and stress reduction are also important for healing anal fissures.
• 😀 Dr. Chung advocates for patient education, helping individuals understand how their body works and how to manage their fissures effectively.
• 😀 Surgery is not the go-to solution for chronic anal fissures in Dr. Chung's practice. He has had great success healing fissures without surgical intervention.

Q & A

What is an anal fissure?

An anal fissure is a small tear or crack in the skin around the anus, often caused by trauma or strain during bowel movements.

What is the difference between an acute and chronic anal fissure?

An acute anal fissure is a recent tear that has been present for up to six weeks, whereas a chronic anal fissure has lasted for more than six weeks and may have additional complications like healing tissue overgrowth or skin tags.

What causes an acute anal fissure?

Acute anal fissures are typically caused by trauma, such as passing a large, hard stool, constipation, or prolonged sitting. They often occur suddenly after a painful bowel movement.

What are some signs that an anal fissure is chronic?

Chronic anal fissures may exhibit signs like overgrown tissue, a sentinel skin tag (which is often mistaken for a hemorrhoid), or scar tissue. The fissure may also be more difficult to heal.

How is an anal fissure diagnosed?

Diagnosis of an anal fissure is primarily based on the patient's history and symptoms. A doctor may also examine the area to look for visible signs like fresh cuts or overgrown tissue, and in some cases, may use a scope to inspect the area.

Why does Dr. Chung say that the distinction between acute and chronic doesn't matter?

Dr. Chung believes the classification between acute and chronic fissures doesn't significantly affect treatment. Instead, he focuses on understanding the patient's unique situation, including lifestyle and diet, to address the root cause and help healing.

What is a sentinel pile or skin tag?

A sentinel pile or skin tag is a small growth of tissue that can form near a chronic anal fissure. It is often mistaken for an external hemorrhoid but is actually a result of the healing process that has become problematic.

What treatments does Dr. Chung recommend for anal fissures?

Dr. Chung suggests a combination of treatments, including topical creams, relaxation techniques, sitz baths, pain management, and lifestyle adjustments, rather than relying on surgery. His approach aims to heal the fissure without invasive procedures.

Why doesn't Dr. Chung advocate for surgery in cases of chronic anal fissures?

Dr. Chung does not recommend surgery because he believes that, with proper treatment and lifestyle adjustments, chronic anal fissures can be healed. He emphasizes his success in healing fissures without the need for surgery over the last five years.

What factors can affect the healing of an anal fissure?

Factors that can affect healing include diet (particularly fiber intake), stress, stool consistency, and lifestyle habits. These elements can either promote or hinder the healing process, so they must be addressed alongside medical treatments.