Rectal fissures symptoms. Diagnosis is unpleasant, but necessary. Diet - proper nutrition

A rectal fissure is one of the fissures that is localized in the inner part of the intestine in the anal area. This disease can occur due to various reasons and call unpleasant symptoms in a sick person. Let us consider in more detail how to treat a rectal fissure at home and what needs to be done for this.

Most often, a rectal fissure develops for the following reasons:

1. A sharp disturbance of blood circulation in the anus. This is usually observed in patients who lead a sedentary lifestyle and do not exercise at all. In such people, blood gradually stagnates in the pelvis, which provokes first, and then the development of a crack in the intestine.
2. Frequent constipation or, conversely, digestive disorders can seriously injure the intestines and give rise to the appearance of cracks.
3. Postpartum injuries very often cause fissures in the intestine. This is explained by the fact that during childbirth the woman greatly overexerts herself. birth canal, which leads to the formation of a crack. Moreover, the situation becomes more complicated if even during pregnancy future mom often suffers from constipation.
4. Anal sex, which leads to intestinal injury.
5. Haemorrhoids ( link), which is not treated in time, contributes to poor circulation. This in turn weakens the anus and makes it more vulnerable to injury and subsequent fissures.
6. Various disorders in the central nervous system (stress, neuroses, depression, etc.) can disrupt the functions of the sphincter and lead to its spasms. In this condition, a rectal fissure is a pattern.

Important! In more than half of the cases, the unstable psycho-emotional state of the patient can lead to exacerbation of chronic diseases, as well as the development of ulcers, pancreatitis and other diseases. Moreover, frequent experiences lead to exhaustion of the body and weakened immunity, so a person becomes more vulnerable to various types pathologies.

1. The anatomical features of the structure of the rectum in some cases make it prone to the appearance of cracks.
2. Improper administration of an enema can easily lead to severe injury to the intestine, infection and the appearance of a crack.
3. Heavy lifting that led to sharp increase intraintestinal pressure and gave impetus to the appearance of a fissure.
4. Impaired tissue nutrition in the rectal area.
5. Smoking and frequent use alcoholic beverages cannot directly affect the formation of a crack, but it makes a person predisposed to this disease.
6. Poor diet (eating too spicy, fatty, fried food) can irritate the rectal cavity, which makes it vulnerable and easily injured.

Features of the forms of intestinal fissures

A crack in the rectal mucosa has two forms of occurrence: acute and chronic. Each of these forms is characterized by its own characteristics.

The acute form of the disease usually develops spontaneously due to intestinal rupture. In this case, the patient exhibits pronounced acute symptoms. His condition is rapidly deteriorating.

As a rule, the acute form of cracks goes away just as quickly. On average, the healing time for an injured intestine is 3-5 days.

The chronic form of intestinal fissure is considered much more serious. It can last for months without causing too much severe symptoms at the patient. Occasionally, the pathology will worsen and make itself felt.

The main danger of this condition is that it can lead to serious complications, because a person will develop inflammation in the body for a long time, and the intestine will become increasingly affected by microbes.

Features of symptoms

The acute form of rectal fissure has following features course and symptoms:

1. At the very beginning of the disease, the intestinal mucous layer is torn. This leads to sharp pain. Over time, the torn edges of the wound become rougher. The width of the crack increases, affecting the intestine even more.
2. Due to the physiological ability of the intestine, it quickly closes and the crack is covered with a small film, but with subsequent constipation, the wound opens again and bleeds.
3. A patient in the acute form of the disease experiences severe itching and burning in the anus. There may also be pain radiating to the perineum and rectum.
4. If an infection is attached to the crack, the pain may become permanent. An elevated temperature and all signs of intoxication of the body (loss of appetite, chills, headache, weakness). In addition, infection of the wound can lead to the development.
5. The appearance of scarlet blood during defecation indicates injury to the capillaries in the rectal area. If it appears dark blood, then this indicates damage to the veins. Such bleeding will be similar to hemorrhoidal bleeding.

Chronic cracks usually have the following characteristics:

1. A person weakens and his immunity decreases due to frequent blood loss. The patient may lose weight and be malnourished.
2. Women experience menstrual irregularities and pain when urinating.
3. Perineal pain may occur.
4. Attacks of angina and arrhythmia often develop.
5. It is difficult and painful for a person to sit for a long time in one position.
6. The patient experiences irritability and fear of defecation.
7. In addition to blood, pus may be discharged from the anus.

Features of symptoms in children

A rectal fissure in a child usually develops due to malnutrition and constipation. The disease manifests itself as pain during defecation and bleeding, which is noticeable on toilet paper.

As a rule, this pathology in children is treated quite quickly. All you need to do is normalize the stool and review the child’s diet.

Symptoms during pregnancy

Because of physiological structure internal organs, women are more prone to problems with bowel movements. Moreover, this statistic increases when a woman is pregnant.

The appearance of a crack during pregnancy can be explained by the following:

1. An enlarged uterus causes compression of the veins in the pelvic area, which leads to poor circulation in the rectum.
2. Due to the influence of hormones that are produced during pregnancy, tissue swelling develops, which leads to increased susceptibility of the intestines to negative influences.
3. At poor nutrition As a pregnant woman, her digestion is disrupted. This leads to the problem of constipation and its direct consequence – anal fissure.

Symptoms of a fissure in the intestine during pregnancy will be:

1. Feeling of fullness in the lower abdomen. Another reason - .
2. Pain and burning in the anus.
3. Sharp spasms during bowel movements.
4. The appearance of a small amount of blood during bowel movements, which does not mix with feces.
5. Frequent constipation.
6. Urinary dysfunction.

Diagnostics

When the first alarming symptoms illness, you should immediately contact a proctologist. Women are also recommended to undergo additional examination by a supervising physician and gynecologist.

After collecting anamnesis, the doctor will conduct a digital examination of the rectum. Externally, the crack appears as a long red ulcer. It can be detected during anoscopy or rectomanoscopy.

To further confirm the diagnosis, the patient is recommended to undergo general clinical tests blood and urine to determine if there is inflammation in the body.

Treatment

Treatment for rectal fissure is selected for each patient individually, depending on the cause of the pathology, symptoms and general neglect of the disease.

Traditional drug therapy provides the following:

1. Prescribing painkillers to the patient in the form of oral tablets and ointments for topical application.
2. Antispasmodics (No-shpa) are prescribed for spasms.
3. At elevated temperatures, the patient needs to take antipyretic drugs (Paracetamol).
4. To facilitate bowel movements and normalize stool, laxatives are prescribed.
5. Very useful to use rectal suppositories based on oils. They will soften the intestine, help reduce pain and heal the fissure. The following drugs of this drug group are usually prescribed:

• candles with sea ​​buckthorn oil;
• Proctosan;
• Relief Advance;
• Posterizan (ointment and suppositories).

In addition, they have an excellent healing effect glycerin suppositories. They can be used not only for the treatment of adults, but also for therapy in children.

1. At infectious lesion intestines and pus discharge, the patient is prescribed strong antibiotics. They must be taken for at least ten days in a row. The dosage and name of the medicine is selected individually depending on the causative agent of the infection.
2. When treated with antibiotics, the patient must be prescribed drugs to restore microflora and improve digestion. The best medicines of this group are Mezim, Hilak Forte, Linex.
3. If stress is the cause of the crack, the patient should be prescribed antidepressants.

Important! If a patient with a fissure in the rectum is pregnant, then most oral medications she is contraindicated to take. In this case, rectal pain relievers and healing ointments based on herbs and oils are usually used.

In addition to drug therapy, treatment of this disease involves performing a number of procedures. The best of them are:

1. Daily use of microenemas with weak solution potassium and oils.
2. Using candles based beeswax.
3. Performing cleansing microenemas.
4. Carrying out sitz baths. To prepare them you need to pour warm water into a basin and dissolve potassium permanganate in it to make pink color. Next, the patient should squat down so that anal passage could be completely washed in the medicinal solution. The duration of this procedure is fifteen minutes.

In addition to potassium permanganate, you can also use medicinal decoctions of herbs that have anti-inflammatory and analgesic effects (chamomile).

It is best to perform sitz baths after a cleansing enema before bed.

Surgical and hardware treatment

If after two weeks drug therapy has not given any improvement, and the patient’s condition remains as acute, he is prescribed surgery. This operation involves partial excision of the intestine and removal of the fissure.

Given surgery be carried out under general anesthesia, so the patient does not feel pain during it. The person regains consciousness when the procedure is completed.

The duration of wound recovery and healing is usually 2-3 weeks. During this time, the person is advised to completely limit physical activity and maintain bed rest.

Most often, such surgical procedures are performed on patients with chronic form cracks that are difficult to treat with medication.

You should be aware that fissure removal does not always involve traditional open surgery. Modern medicine does not stand still and new treatment methods are already being actively practiced.

For example, an operation called lateral sphincterotomy, as well as an infrared coagulator, is considered very effective.

Medical nutrition

One of the most important roles in the treatment of rectal fissures is proper nutrition. The diet requires compliance with the following mandatory rules:

1. Alcohol and sweet carbonated drinks should be completely excluded from the diet.
2. It is necessary to enrich the menu with products containing fiber (vegetables and fruits). It will improve bowel function and soften stool.
3. Dried apricots, raisins, prunes and other dried fruits, as well as decoctions from them, will help improve bowel movements.
4. It is important to completely exclude the following products from the menu:

• fat;
• roast;
• salt;
• sugar and confectionery;
• White cabbage;
• beans;
• fast food;
• semi-finished products;
• potato;
• bakery products (only biscuits are allowed).

1. The basis of the menu should be steamed or boiled dishes. At the same time, you should also give preference to homemade food rather than store-bought semi-finished products.

Important! People often fail to eat normally in work time, so they stop their hunger with coffee and various sweets. If you have a rectal fissure, such a diet is extremely harmful. The way out of this situation can be homemade meals that need to be packed in convenient lunch boxes. They will not only be able to satiate a person healthy food, but will also keep it fresh.

1. The patient's menu should include low-fat fermented milk products (cottage cheese, sour cream, kefir) every day. They will improve digestion.
2. It is recommended that the patient eat frequently, but the portions should be small.
3. Do not eat too hot or cold food.
4. It is important to avoid overeating so as not to complicate digestion and bowel movements.
5. If constipation is a problem, it is recommended to further enrich your diet. vegetable fats(olive or sunflower oil).

Possible complications

In the absence of timely diagnosis and treatment, the patient may develop the following complications:

1. Bleeding. At first it will be minimal and occur only after defecation, but over time the loss of blood will become more abundant. This in turn can lead to anemia, dizziness, weakness and headaches.
2. The development of paraproctitis is associated with infection entering the deep layers of the intestine.
3. Intestinal inflammation.
4. The entry of pathogenic bacteria, which will lead to an abscess and suppuration.
5. Sometimes the infection spreads to the prostate gland, which threatens the development of prostatitis in men.
6. Chronic pain that will manifest itself not only during the act of defecation, but also during physical activity and seat.
7. The spread of a fissure along the intestine can lead to sharp deterioration the patient’s well-being and the penetration of feces into the intestinal cavity. This, in turn, threatens serious infection and intoxication of the body. This condition requires immediate surgical treatment.

Prevention

To prevent the development of a fissure in the rectum, you should adhere to the following doctor’s recommendations:

1. Avoid stress and nervous overstrain. If necessary, take sedatives and antidepressants, but only as prescribed by a doctor.
2. Completely stop smoking and drinking alcohol.
3. Maintain hygiene of the genitals and anus.
4. Avoid eating fatty, spicy, fried and smoked foods.
5. Workout. It could be running, dancing, fitness, yoga or something else. The main thing is that the classes are regular and put stress on the body.
6. Avoid excessive physical fatigue and heavy lifting.
7. Have good sleep.
8. Use soft toilet paper.
9. During pregnancy, monitor your stool and if constipation occurs, consult a doctor.
10. It is very important to have correct posture during defecation. It has been proven that if you raise your legs higher while sitting on the toilet and rest them on the stand, the rectum experiences more pressure, making the entire act of defecation easier and faster.

Moreover, you should not sit on the toilet for too long and strain your intestines, as this leads to injury.

1. Temper yourself to improve your immunity.
2. Take vitamin complexes.
3. When the first symptoms of a fissure appear, you should immediately contact a proctologist.
4. Do not self-medicate, as it can lead to chronic disease.

In most cases, the appearance of a fissure in the intestine can be prevented. To do this, it will be enough to follow the above tips.

Anton palaznikov

Gastroenterologist, therapist

Work experience more than 7 years.

Professional skills: diagnosis and treatment of diseases of the gastrointestinal tract and biliary system.

In terms of prevalence, rectal fissure ranks third among intestinal diseases (after hemorrhoids and colitis). It is a longitudinal (ellipsoidal, triangular or linear) tear in the anal mucosa, the size of which can vary from a few millimeters to 1.5-2 cm.

Often the crack is combined with internal hemorrhoids. Women are most susceptible to the disease due to their anatomical features.

Most often, the disease develops as a result of chronic constipation and trauma to the rectum with solid feces.

Why does it occur?

The appearance of a crack can be caused by several factors.

The most common of them are mechanical injuries and inflammatory process in any department gastrointestinal tract. A combination of both factors is also possible.

Regardless of the specific location of the inflammation, even when located in upper parts Gastrointestinal tract, it significantly increases the risk of developing the disease. This is explained by the fact that all organs digestive system communicate with one another, and infectious process in one of the departments leads to the spread of pathology to the entire tract or its individual sections.

In children, a crack often occurs due to a combination of these two factors. This phenomenon is typical for helminthiasis. If there are worms in the lower intestine, swelling and inflammation are observed. Worm eggs lead to the appearance of severe itching causing the child to scratch the area anus, which leads to mechanical damage to the mucosa. The condition is complicated by the passage of feces.

A favorable factor for the appearance of cracks in children is also their immaturity. digestive organs, as a result of which occur frequent disorders stool: diarrhea or constipation. With constipation, the delicate mucous membrane of the rectum is damaged during the passage of solid feces, and with diarrhea, the liquid mass causes irritation and swelling of the inner surface of the intestine.

Other possible causes of a crack include:

• weakening of the pelvic floor muscles;
• birth injuries;
• chronic pathologies of the gastrointestinal tract;
• disorders of the digestive system, leading to chronic diarrhea or constipation;
• inflammatory process in one of the intestinal sections;
• laxative abuse;
• rectal injuries (possible during anal sex).

Symptoms

The first sign of a fissure is pain in the anus. The pain may occur unexpectedly, intensifies with defecation and resembles painful sensations for hemorrhoids. Unlike the symptoms of hemorrhoids, with a fissure the pain is much stronger, sharper and longer lasting. It forces a person to delay bowel movements, which leads to the development of constipation and further complicates the situation.

Often there is pain in the perineum and sacral area, which leads to urination disorders and disruption of the rhythm of the menstrual cycle.

The main signs of a crack are:

• sharp pains during and after bowel movements;
• spasm of the anal sphincter as a result of severe irritation nerve endings;
• bleeding from the anus - their intensity is less than with hemorrhoids: mainly these are minor traces of blood in the stool or on toilet paper;
• frequent constipation;
• itching, often with perianal eczema;
• burning sensation with diarrhea.

Depending on the complex of symptoms, two forms of the disease are distinguished: acute and chronic.

For acute form There are three main symptoms:

• intense pain during defecation (may persist after it - about 15 minutes);
• bloody discharge from the anus;
• spasm of the anal sphincter.

As a result of incorrect or incomplete treatment, the disease becomes chronic stage.

At chronic types of pain are not as severe, but they last much longer. Pain often occurs without defecation. They can be triggered by prolonged sitting. There is often a risk of complications.

Both chronic and acute forms are characterized by difficulty in defecation associated with severe pain. A kind of vicious circle is formed: cracks lead to chronic constipation, and constipation causes complications in the course of the disease

If children have the disease, severe pain during bowel movements causes them to be capricious, cry, and children avoid the potty. Retention of feces in the intestines leads to their compaction. We have to resort to the use of medications.

Diagnosis of rectal fissure

With characteristic clinical picture For rectal fissures, examination and digital examination are performed to confirm the diagnosis.

With intense pain syndrome, and also to avoid infection, retromanoscopy is generally not practiced, except in cases where it is necessary to exclude or confirm the presence of a rectal tumor. In this case, anesthesia is certainly performed.

Upon examination, a defect of the mucous membrane of a linear nature is detected with smooth edges- at acute course diseases, triangular or oval with scar tissue and overgrown granulations - in chronic.

There are also lab tests: in adults - for syphilis, HIV, hepatitis, blood sugar, in children - for the presence of worm eggs (stool analysis).

Treatment

Rectal fissure is treated mainly by medication. The goal of therapy is:

1. Eliminating constipation, ensuring regular soft stools.
2. Anesthesia.
3. Healing wounds and relieving possible inflammation.
4. Treatment of concomitant diseases.

To soften the stool, patients are prescribed a special diet. The diet is based on plant and dairy products. Plant foods contain a large number of fiber, which increases intestinal motility and helps cleanse the body of waste products, and dairy products, by increasing the number of beneficial lactobacilli, help restore normal microflora.

Spicy, salty, flour, and fried foods should be excluded from the menu.

The diet should contain carrots, beets, green apples, prunes, dried apricots, and pumpkin. You can drink kefir at night, and vegetable salad with olive or other vegetable oil for breakfast will start the gastrointestinal tract and relieve chronic constipation.

If necessary, mild laxatives and cleansing enemas with a weak antiseptic solution are prescribed.

To relieve pain, patients are prescribed warm baths and microenemas. Great for reducing inflammation sea ​​buckthorn candles, as well as suppositories with methyluracil or benzocaine. To heal wounds and facilitate bowel movements, patients are prescribed glycerin suppositories.

Since in many cases the fissure is a consequence of diseases of the gastrointestinal tract, appropriate treatment of the underlying pathology is simultaneously necessary.

Basically, conservative methods give positive results.

In its absence and the disease progresses to the chronic stage, surgery may be prescribed.

The essence surgical intervention consists of excision of the affected area of ​​the rectum.

Modern medicine offers low-traumatic methods: cryodestruction and laser coagulation.

These methods do not require general anesthesia and long-term hospital stays.

For significant cracks, classical surgery is indicated.

A sphincterectomy is performed under general anesthesia. Its purpose is to weaken the sphincter muscle fibers to relieve spasm. Then the edges of the crack are excised, after which the edges of the wound are sutured.

During the rehabilitation period, which lasts about a month, local anti-inflammatory therapy and strict adherence to a diet are prescribed to prevent constipation.

Traditional medicine tips

From traditional methods You can use rectal suppositories made from beeswax. Melt the wax (150 grams), add chamomile, plantain and motherwort (1 pinch each), stir thoroughly, roll up candles and put them in the refrigerator.

Use three times a day.

Another recipe: prepare an ointment based on infusion of chamomile, St. John's wort and calendula. Grind herbs, pour hot olive oil(ratio – 1:3). Let cool, put in the refrigerator. Use the ointment to lubricate the anus.

Rectal fissure(anal tear) is a defect in the mucous layer of the rectal canal, ranging in size from a few millimeters to 2.5 centimeters. Arises as a result of or is a complication. Most often, anal tear occurs in women and children. In men this pathology is found less frequently.

When the rectal mucosa is damaged, the integrity of small blood vessels and nerve endings is disrupted. Therefore, anal tear is accompanied by pain and bleeding.

In the acute stage of the disease, the anal tear has a linear shape and clear boundaries. In a chronic course, the mucosal defect acquires an oval shape with uneven, dense edges, reminiscent of a deep ulcer. This is due to swelling and inflammation of the surrounding tissues. Acute stage the pathological process can last up to 6 weeks, chronic fissure doesn't heal anymore a long period time. Anal tears can be located on the anterior, posterior and lateral walls of the rectal canal.

Acute form

Chronic form

Causes of rectal fissures

Mechanical factors

Inflammatory factors

Other factors

The diagnosis of rectal fissure is made based on the patient’s complaints (itching, pain in the anus, bleeding) and an objective examination by a medical specialist.

Rectal examination

A proctologist or surgeon performs a digital examination of the walls of the rectum. Palpates the location of the anal fissure, its size, shape and configuration of the edge, as well as the presence of internal hemorrhoids and traces of bleeding on the glove. The examination may be difficult if there is increased tone of the anus muscles. The doctor also examines the anal ring area for the presence of external hemorrhoids and areas of inflammation (swelling, redness, scratching).

Laboratory research methods

• A complete blood count is necessary to detect anemia due to prolonged bleeding of a rectal fissure. Also helps in diagnosing infectious inflammation.
• Blood test for dangerous diseases(HIV, syphilis, hepatitis B and C), in which one of the symptoms may be anal tear.
• Taking swabs for enterobiasis and stool for worm eggs if there is a suspicion of helminthic infestation in children and adults.
• Blood test for sugar. At diabetes mellitus The process of blood circulation in the body is disrupted, and the ability of tissues to regenerate is reduced. Pathological changes most often affected lower limbs and pelvic organs. This leads to the appearance of cracks in the heels and the development of hemorrhoids with long-term non-healing anal tears in the rectal canal mucosa.
• Sowing on pathogenic fungi and bacteria. Anal fissure may be specific symptoms actinomycosis, intestinal tuberculosis.

Instrumental research methods

Treatment

Basic principles:

1. In the acute course of anal tear, conservative (drug) therapy is chosen.
2. Chronic rectal fissure requires surgical intervention.
3. Treatment should be aimed at pain relief, elimination of inflammation and regeneration of the rectal mucosa.
4. Be sure to eliminate the symptoms (constipation, diarrhea, spasm of the anal sphincter) that provoke the development of rectal fissures.
5. Treatment of associated pathological conditions(hemorrhoids, irritable bowel syndrome, Crohn's disease, nonspecific ulcerative colitis etc.), causing exacerbation anal tear.

Diet

Principles of nutrition

Products

Diet for rectal fissure is aimed at regular stool. Properly selected food products prevent the swelling of veins and inflammation of hemorrhoids in the rectal canal. Fermented milk products restore balance and accelerate the healing process of cracks.

Diet is supportive, but necessary method treatment of anal tear. High-quality nutrition allows you to achieve successful results in conservative therapy and surgery.

Drugs

Drugs for the treatment of rectal fissures should have the following effects:

• anesthesia;
• relieving inflammation;
• elimination of spasm;
• regeneration (healing);
• stopping bleeding;
• relaxation of the chair.

(suppositories, ointment) – combination drug. Reduces inflammatory manifestations, eliminates pain, itching, heals anal tear (drying effect) and prevents infection of the mucosal defect. The ointment is applied externally, applied in a small layer in the anus. Maybe indoor use using an applicator into the lumen of the rectum. Candles are inserted through anal hole into the rectal canal. Both forms of the drug are used twice a day (morning and evening) after bowel movements and obligatory hygiene procedures anus. Treatment for no more than 10 days.

The drug rarely causes side effects. Most often this is allergic intolerance (dermatitis, urticaria). In such cases, after use dosage form itching intensifies, swelling and rashes appear. The drug should be discontinued and an alternative replacement should be found.

"Natalsid"(suppositories) - a medicine based on sodium alginate, obtained from seaweed - kelp. It has anti-inflammatory, wound-healing and hemostatic effects. Rarely causes side effects, it is allowed for pregnant and breastfeeding women. For anal tear, use 1 suppository 2 times a day after bowel movements and hygienic toilet of the anus. Treatment is continued for 7-14 days.

"Gepatrombin G"(ointment, suppositories) is an effective drug for the treatment of rectal fissures combined with thrombosis of hemorrhoidal veins. It has anti-inflammatory, analgesic, antithrombotic (promotes the gradual resorption of blood clots and prevents the formation of new ones). Relieves swelling and itching, accelerates the process of tissue regeneration. The drug is contraindicated for people with allergic intolerance and impaired blood clotting.

The ointment is applied externally to the affected areas 2 to 4 times a day, or through an applicator into the lumen of the rectum. Rectal suppositories are inserted into the anus in the morning and evening, 1 piece each. For getting visible effect treatment should be continued for 1-2 weeks.

"Levomekol"(ointment). Effectively heals anal tears and prevents purulent inflammation. The ointment is applied externally to the anus 3-4 times a day.

"Relief"(ointment, suppositories) – a preparation containing shark liver oil.

Has a hemostatic and anti-inflammatory effect, helps fast healing anal tear. Easily eliminates itching and swelling of tissues.

Suppositories are used up to 4 times a day: after hygiene procedures and spontaneous bowel movements. The ointment can be used for external application to areas of inflammation or for rectal administration through the applicator. Prescribed according to the same scheme as suppositories.

In case of rectal fissures, they restore the mucous membrane well and prevent bleeding candles with methyluracil, sea ​​buckthorn oil and benzocaine (“Anestezol”). They also relieve pain and reduce swelling.

Laxatives for constipation

"Glycerol"(suppositories) – drug irritating effect. Has a direct effect on mucosal receptors lower sections intestines. Stimulates peristalsis and excretion of feces. Active substance(glycerol) of the drug softens hard stool, bowel movements become painless and regular. Medicine does not disrupt work digestive tract and is not addictive. Approved in pediatrics. Available in 2 dosages: 1.24 g and 2.11 g of glycerol. Children under 3 years old are prescribed half a suppository (1.24 g) once a day, from 3 to 7 years old - 1 suppository (1.24 g) once a day. Over 7 years of age and adults, 1 suppository (2.11 g) per day is recommended.

The drug is used in the morning, half an hour after breakfast. The candle is inserted into the anus while lying on its side. The laxative effect occurs within 10-15 minutes.

They have a similar effect Bisacodyl suppositories.

"Mikrolaks"– combined laxative drug. Available in the form of tubes with a solution -. The drug increases the absorption of water in the intestines, dilutes dense stool, and facilitates bowel movements. Emptying occurs within 5-15 minutes after using the drug. The tip of the microenema is inserted completely into the anus (for children under 3 years old - only halfway), after which the contents of the tube are squeezed out. The drug is used once a day. Not used for long-term treatment.

Mild laxatives () in syrups are also effective: "Duphalac", "Normaze", "Lactusan".

Antispasmodics to relieve spasm of the anal sphincter

"No-shpa"(tablets) is used to eliminate any spastic conditions of the gastrointestinal tract. Prescribe 1-2 tablets (40-80 mg) 2-3 times a day. For maximum effectiveness, the drug should be taken an hour after eating with a glass of drinking water.

"Duspatalin"(tablets) eliminates increased tone muscles of the digestive tract. Take 1 tablet 3 times a day. When a therapeutic effect is achieved, the dose is gradually reduced.

In cases of severe pain and spasm of the anal sphincter, rectal suppositories with antispasmodics help well: "Buscopan", "Papaverine", "Anuzol".

Antidiarrheals

Rectal fissure associated with chronic diarrhea occurs much less frequently than with constipation. Frequent loose stool irritates the mucous membrane of the rectal canal and contributes to the formation of a defect. To treat an anal tear, it is necessary to eliminate the cause that caused its appearance. Appointed antidiarrheal drugs: "Imodium", "Lopedium", "Uzara", "Loflatil". To remove toxic substances from the body, the following are additionally recommended: “Smecta”, “Enterosgel”, “Polysorb”, “Lactofiltrum”.

Surgery

Conservative treatment helps only when sharp crack rectum or minor inflammation of chronic anal tear. Therapy can be carried out for 2 months. If treatment is ineffective, as well as cicatricial changes in the mucosal defect, spasm of the rectal sphincter, or the presence of complicated hemorrhoids, surgery is required.

Minimally invasive surgery – laser coagulation

Used when small sizes defect of the rectal mucosa, absence of anal sphincter spasm (20-30% of cases), relapses and complications. The procedure is carried out under local anesthesia, does not require a long recovery period.

Progress of the procedure. A surgical speculum is inserted through the anus into the rectal canal, the crack is fixed with a clamp and excised using a laser beam. Formed fresh wound which heals quickly. Muscle fibers the anus is not injured, therefore, the possibility of relapse is excluded.

Recovery period. The patient should not get up for an hour. After the procedure, a gauze swab soaked in an antiseptic solution is inserted into the anus. The wound is disinfected every day for a week and after defecation. The surgeon also controls the patient’s stool and prescribes therapeutic nutrition and laxatives (if necessary). The patient's condition improves on the 2nd day after laser coagulation. But the wound heals completely after 3-4 weeks.

Laser coagulation is the most acceptable method of treating anal fissure.

Radical surgery - surgery to remove an anal tear

Used after the course conservative treatment(elimination of pain, spasm, acute inflammation, constipation). The operation is recommended for long-term chronic course of the pathological process, the presence of spasm of the anal sphincter, as well as for significant defects in the rectal mucosa and its scarring.

Progress of the procedure. To access the rectal canal, the anal sphincter muscles are dissected, then the edges of the fissure are excised using a scalpel or radio knife (Surgitron apparatus). The fresh wound is sutured or left without suturing (Gabriel operation). If there is a spasm of the rectal sphincter, the muscles of the anal ring are excised. Sphincterotomy gives high efficiency(in 90% of cases) in the healing of rectal fissures. The operation is performed under general anesthesia or local (spinal) anesthesia.

Recovery period. After surgery, daily antiseptic treatment of the wound is carried out, healing medications are prescribed, and constipation is prevented (diet, laxatives). On the first day after surgery, the patient should not get up. In the absence of spontaneous bowel movements, a cleansing enema is prescribed on the 3-4th day. After each bowel movement, the patient needs to wash himself; using regular toilet paper is not recommended.

On the first day after surgery - complete failure from food, abundant drinking regime. Then they begin fractional meals (up to 7 times a day in small portions). Slag-free treatment is prescribed for 3-5 days. salt-free diet. From 3 days onwards, fermented milk products and vegetable fiber are allowed. Recommended dishes include crumbly porridges, vegetables in the form of purees and salads, meat in the form of cutlets or soufflés.

Discharge 7-10 days after surgery.

Folk remedies

For the treatment of anal tear in traditional medicine actively use herbs. To improve digestion and reduce inflammatory symptoms, use tea made from chamomile, sage, and St. John's wort.

Prepared for local use herbal infusions. A collection of chamomile, sage, oak bark and yarrow copes well with inflammation, bleeding and pain of a rectal fissure. Take 2 tablespoons of each herb, add a liter boiled water and cook over low heat for about an hour. The resulting broth is filtered through a sieve and poured into a basin, diluted clean water(2-3 l) to a temperature of 38-39°C. They sit in a basin with a medicinal solution and warm up for 20 minutes. The procedure is recommended to be carried out after spontaneous bowel movements or bowel movements after the introduction of microenemas. Warm baths with a slightly pink (several drops or granules of the product per 2-3 liters of water) solution of potassium permanganate are also effective. Do not use high concentrations of the drug, as this may cause burns.

Herbal decoctions can be used as microenemas. To do this, you need a syringe with a volume of 50 ml and warm (37 ° C) medicinal solution: Add a glass of boiling water to 2 tablespoons of herbs and cook over low heat for 10 minutes, cool to the desired temperature. The procedure is carried out after bowel movement. The tip of the syringe is lubricated with cosmetic Vaseline and carefully inserted into the anus while lying on its side. Squeeze out the medicinal solution (volume 30-50 ml) and remove it from the anus. You should try to keep the liquid in the rectum for an hour. You can also use juices for douching. medicinal plants: aloe and kalanchoe.

You can make herbal candles at home. For this you will need herbs - plantain, motherwort and flowers pharmaceutical chamomile. Take 1 teaspoon of raw materials. Then melt 150 g of beeswax, add 3 teaspoons of various herbs to it and stir. The resulting mixture is poured into small molds and placed in the refrigerator to harden. You should get 10 suppositories, which are good for relieving inflammation and itching during anal rupture. Raw materials should only be stored in the refrigerator.

For microenemas, mix aloe juice, liquid fish oil and a raw chicken egg. All ingredients are taken 1 tablespoon at a time and mixed. The mixture is used for douching before bedtime. Minimum rate home treatment- 10 days.

Complications of the disease and prognosis for life

• anemia due to prolonged bleeding;
• inflammation of direct and sigmoid colon(proctitis,);
• bacterial infection of nearby tissues (acute paraproctitis);
• chronic paraproctitis with the formation of a rectal fistula (anal tear affects the muscular layers of the intestinal wall);
• bleeding (constant irritation of blood vessels during bowel movements).

At timely application the patient and the effectiveness of treatment measures, cure occurs in 60-90% of cases.

The prognosis for life is favorable. As a result long absence adequate treatment pathological process from acute to chronic, complications appear. In this case, surgery is required, during which the patient’s recovery and the absence of relapses are also possible.

Prevention

• abundant drinking regimen (up to 1.5-2 liters of clean water per day);
• predominance in diet vegetable fiber(fresh vegetables, fruits, dried fruits, cereals, bran).
• spicy, salty, fatty, fried, smoked foods are excluded;
• must be maintained active image life: move more, do exercises, walk daily;
• limit prolonged sitting (driving a car, cycling). When working in an office environment, do a warm-up every 2-3 hours (walk around, stretch);
• avoid constipation. You can use mild laxatives that are not addictive.
• eliminate alcohol and cigarettes;
• after defecation, wash the anus cool water or use wet toilet paper.

Almost everyone has heard about it, but some know about this problem only by hearsay, while others have this disease and are trying to solve the problem in one way or another.

What causes rectal cracks to appear and how to treat such diseases using traditional methods?

Not everyone knows that a burning sensation, and in some cases, is caused not by a venous disease, but by a violation of the integrity of its mucous membrane.

Often this disease relates to acute diseases and can last about four weeks. In this case, this is already a surgical pathology that requires urgent treatment.

Crack to crack - discord

Cracks can have several forms of disease:

1. Linear. It is located on the mucous membrane of the anus, spreading to the skin of the anus. Cracks can be of different depths and sizes. This form is one of the most common.
2. Chronic. This is usually a continuation of a linear shape. The disease is characterized by periodic improvements and deteriorations. This process is facilitated by prolonged exposure various factors leading to this problem.

Factors provocateurs

This type of disease occurs for fairly simple reasons:

1. Chronic constipation. This forces a person to constantly strain, which increases the pressure in the veins of the rectum.
2. Sedentary or sedentary lifestyle life. Causes stagnation in the pelvic veins.
3. Mechanical injury. May occur due to hard stool due to constipation. Also possible when using toilet paper Low quality. This type of injury also includes anal sex and instrumental study rectum.
4. Childbirth. Quite often, during the period of pushing, rectal cracks appear. This is very bad, as a perineal rupture of varying degrees may occur.
5. Personal hygiene violations. This includes diaper rash, insufficient wiping after bowel movements, etc.
6. Changes in the mucosa against the background of diarrhea, dysbacteriosis, proctitis, helminthic infestation.

How does the problem manifest itself?

It’s immediately worth noting that the deeper (or longer) the pain, the stronger the pain.

At first discomfort appear during defecation or mechanical intervention. Later, the inflammatory process occurs, and pain can become permanent or periodic.

The type of pain with intestinal fissures is quite varied: pinching, burning, stabbing, pulling or pressing. These types of pain are typical for severe swelling and the inflammatory process.

In the chronic course of the disease, the pain is spasmodic in nature, intensifying with bowel movements.

And can be provoked by tight, synthetic underwear, sedentary life, diarrhea and constipation. The larger the crack, the more pronounced the discomfort.

The discharge of scarlet blood during defecation is the result of the destruction of capillary walls in anal area. If the crack goes deep, veins can also be damaged. In this case, similar bleeding will occur (the appearance of dark venous blood).

All of the above symptoms can also occur with such serious illnesses as well as colon cancer.

Therefore, if you have any troubles associated with discomfort and pain in the anal area, you should definitely contact a specialist and perform a rectoscopy.

help yourself

To safely get rid of a rectal fissure at home, first of all, you need to follow the rules of hygiene and eliminate factors that provoke the formation of wounds in the anal area.

What can be done to make the cracks heal and not appear again?

Follow simple rules:

All these tips and rules can be successfully used at home both when rectal fissures occur and to prevent this problem.

we are what we eat

The basis of treatment for rectal fissures is special diet, which normalizes stool regularity.

At the same time, nutrition should not only be gentle, but also complete. Should not be present in the patient's diet fried foods, smoked meats, spices, spicy and salty dishes, alcohol - this is if a person suffers from constipation.

Instead, you need to give preference to foods rich in fiber.

These are:

• legumes (beans, beans, lentils, peas);
• grains (oats, rye, barley);
• fruits (peaches, apples, quinces, prunes, avocados, raisins);
• vegetables (broccoli, asparagus, cauliflower, spinach).

For constipation, it is advisable to eat according to the following principle:

1. Contrast breakfast: drink 200 ml of cool, non-concentrated juice, and after 20 minutes take hot oatmeal.
2. 30 minutes before lunch: take on an empty stomach dessert spoon olive, sunflower or camphor oil.
3. Dinner and supper: prepare steamed or boiled dishes from foods rich in fiber. We talked about them a little higher.
4. Also need to remember drinking plenty of fluids (about 3 liters per day).

If you have diarrhea you should avoid:

• carbonated drinks;
• fruit juices;
• fermented milk products;
• smoked meats;
• coffee;
• spices;
• fresh vegetables and fruits;
• mushrooms;
• sweet pastries;
• pickles and all flour (except white bread).

Treatment menu for diarrhea should consist of something like this:

1. Breakfast: weak black tea, 1 boiled egg, congee 200 ml, bran crackers, fresh banana 1-2 pcs.
2. Dinner: low-fat beef or fish broth, white bread crackers, rice porrige, blackcurrant or lingonberry compote.
3. Dinner: baked lean meat or steamed fish, oatmeal, bran bread, baked apple, jelly made from lingonberries and black currants.

Using folk recipes

When following a diet, you must not forget about local treatment cracks Anti-inflammatory and antiseptic sitz baths prepared at home are very helpful.

To do this, use a decoction of oak bark and chamomile (1:2 ratio). The temperature of the solution should not be higher than 30°C. The duration of the procedure is at least 15–20 minutes.

As medicinal decoction You can also use calendula, yarrow, burnet, blueberries, celandine, nettle, and viburnum bark.

How to properly make a decoction of medicinal herbs

Pour 2-3 tablespoons of dried inflorescences, berries or roots into 200 ml of boiling water, leave in a water bath for 20 minutes, then leave for 1 hour in a tightly sealed container. It would be good if it was a thermos.

Therapeutic compresses

You can also use compresses, which are no less helpful in getting rid of rectal cracks. We invite you to familiarize yourself with the most effective of them:

Cracks should be treated when the first symptoms appear. Do not hesitate to contact specialists for help and do not self-medicate.

Let us remind you that the symptoms we talked about earlier may also apply to more serious illnesses, including oncology. Take care of yourself and always be healthy!

Rectal fissure is a pathological process that occurs with severe pain in the perineal area, burning inside the intestines and in the anus. The disease most often occurs in women aged 18 to 50 years, but older men are also susceptible to it, although in in rare cases. A rectal fissure is also found in children, especially young children.

Symptoms of rectal fissure

The first thing that happens to a person when a rectal fissure appears is pain in the anus. They occur spontaneously during the day, but are especially disturbing during bowel movements. When such symptoms appear, rectal fissures indicate an acute form of the disease. Pain after bowel movement indicates a chronic course of the disease. Sometimes patients confuse the signs of this phenomenon with hemorrhoids, but in fact this is incorrect, since a fissure in the rectum brings more prolonged and sharp pain, which can make a person scream involuntarily during the next attack. Because of this inconvenience, we have to deliberately delay feces in the intestines, preventing them from exiting. The consequence of this process is constipation. The consequences of rectal fissures include the appearance of pain in the perineum and sacrum, which makes urination difficult and disrupts menstrual cycle and provokes angina attacks.

The main symptoms of a rectal fissure are as follows:

• Anal sphincter spasms, which can be explained severe irritation nerve endings located in this area;
• Minor bleeding from the anus, which can be seen in stool or as small marks on toilet paper. This fact distinguishes a rectal fissure from hemorrhoids, in which the bleeding is more profuse;
• Burning with diarrhea;
• Severe pain during defecation, sometimes barely tolerable;
• Constipation and bloating;
• Violent itching with perianal eczema.

A rectal fissure in children can be noticed upon examination. The edges of the damage are inflamed. The child tries to avoid defecation and reacts painfully to any touch to the affected area.

The acute form of the disease includes almost all of the above symptoms, however chronic course has some differences. In this case, symptoms arise from untreated primary damage to the rectum and are characterized by less severe sensations. But this form is dangerous due to serious complications.

The type of rectal fissure can be diagnosed both based on the patient’s complaints and using special equipment.

Treatment of rectal fissure

Treatment of rectal fissures is carried out conservatively and surgical methods. Patients are prescribed drugs for external use as gels, baths, suppositories and ointments. In an adult, complete healing of the intestine rarely occurs, but modern medicine can eliminate symptoms and reduce the likelihood of their reoccurrence.

If the disease has already entered the chronic stage, then surgery is necessary for a rectal fissure, during which an intestinal excision is performed.

A rectal fissure manifests itself with corresponding symptoms from several weeks to several months and requires urgent treatment, because all sorts of harmful microorganisms can get into the wound.

For effective treatment it is necessary to adhere to a strict diet, which is based on the consumption of liquid and light foods that do not irritate the intestines and soften the stool. Preference should be given to natural fermented milk products and bran, which normalize the functions of the gastrointestinal tract and relieve constipation. The doctor prescribes laxatives and oils/ointments to relieve pain.

The prognosis for treatment of rectal fissures is favorable in 90 percent of cases.

Alternative treatment for rectal fissures

Among the folk remedies for the treatment of rectal fissures, ointments, compresses and tinctures made from natural fats, herbs and food are used. Let's describe some recipes that will help get rid of intestinal problems:

• A tablespoon of three-year-old aloe vera juice is mixed with a spoon fish oil and chicken egg, mix thoroughly and douche into the anus. For recovery, a course of at least 10 procedures will be required;
• Dandelion root powder is taken orally, a teaspoon three times a day. It is also recommended to combine this traditional treatment rectal fissures with an infusion of yarrow herb, that is, wash it down with a mixture of dandelion. To prepare the product you need 2 tsp. Pour a glass of boiling water over the herbs and leave for half an hour. This tool helps especially with chronic illness;
• It is recommended to eat one teaspoon of pre-steamed bran three times a day. It is allowed to add them to food, then it is recommended to gradually increase the dose;
• To relieve inflammation and speed up healing, you should stop using toilet paper after bowel movements. As an alternative, washing with clean water or a decoction of healing herbs is best;
• Boil 4 medium onions in half a liter of milk, then sit over the hot broth so that the steam gets into the affected area. It is recommended to perform the procedure once a week.

At timely treatment Surgery for a rectal fissure is not required.