Understanding Fistula and Fissure: Key Distinctions

1. Fistula vs. Fissure: Understanding the Difference Anorectal conditions can cause significant discomfort, yet many patients—and sometimes even doctors—confuse anal fistulas and fissures. Though both affect the same area, they have different causes, symptoms, and treatments. Understanding these differences is crucial for proper diagnosis and effective treatment.

2. What Is an Anal Fissure? Definition A small tear in the lining of the anal canal, exposing sensitive nerve endings Causes Chronic constipation, passing hard stools, or prolonged diarrhea Symptoms • Sharp, burning pain during or after bowel movements • Visible blood on toilet paper • Anal muscle spasms • Persistent discomfort lasting hours

3. What Is an Anal Fistula? Definition An abnormal tunnel between the inner anus and surrounding skin Causes Develops due to infection or abscess near the anal glands Symptoms • Persistent pain • Swelling near the anus • Pus or fluid discharge • Recurring infections or fever

4. Key Differences: Fistula vs. Fissure Feature Anal Fissure Anal Fistula Cause Tear due to hard stool Infection leading to abscess Symptoms Sharp pain, bleeding Discharge, persistent pain Appearance Small crack in anal lining External opening or swelling Duration May heal naturally Needs surgical treatment Treatment Topical creams, surgery Surgery, drainage procedures Knowing these differences is crucial when seeking appropriate treatment for your condition.

5. Diagnosis Process Physical Examination Advanced Diagnostic Tools Doctors start with a thorough examination: For complex cases, especially fistulas: • Fissure: Often visible as a small tear • Anoscopy • Fistula: May require deeper inspection to locate the tract • MRI scans • Endoanal ultrasound These methods help map the fistula's path before recommending treatment.

6. Treatment Options for Fissures Conservative Management Advanced Procedures • Increased fiber intake • Botox injections to relax muscles • Proper hydration • Lateral internal sphincterotomy for chronic cases • Sitz baths • Topical medications Most acute fissures heal within 4-6 weeks with proper care. The best approach ensures tailored treatment for faster healing.

7. Treatment Options for Fistulas Unlike fissures, fistulas rarely heal without surgery. Several surgical techniques are available: Fistulotomy Seton Placement Simple procedure for uncomplicated fistula tracts For complex fistulas, using a thread to gradually cut through Laser Fistulotomy LIFT Procedure FILAC technique using laser technology for minimal invasiveness Ligation of intersphincteric tract for complex cases Recovery typically takes 4-8 weeks depending on the fistula's complexity.

8. Prevention and When to Seek Help Prevention Tips When to See a Specialist • Maintain proper hydration Seek medical attention if you experience: • Eat fiber-rich foods • Persistent anal pain • Avoid straining during bowel movements • Bleeding during bowel movements • Address constipation promptly • Swelling or discharge near the anus Early intervention improves outcomes and shortens recovery time.

9. Dr. Daniel Serralta Address Phone no. Website C/o - Saudi German Hospital, Hessa Street 331 West Al Barsha 3, Exit - 36 Sheikh Zayed Rd - opposite of American School - Dubai +971 568 05 4323 Dr. Daniel Serralta