When a Sphincterotomy Might Make Sense for Your Anal Fissure

Each year in the United States, between 240,000 and 342,000 anal fissures develop, sending patients on a quest for relief from this painful condition.

If you’re frustrated by the lack of results after trying to address your anal fissure conservatively, you’re not alone — about 40% of anal fissures go on to become chronic problems. When this happens, a sphincterotomy may be the best solution.

As experts in colorectal health, the extensive team of board-certified specialists at Fairfax Colon & Rectal Surgery has extensive experience with anal fissures. And what we’ve found is that when conservative efforts fail, one of the best ways to put an end to painful anal fissures is through a sphincterotomy, which is far less complicated than it sounds. Let’s take a look.

Anal fissure basics

To make sure that we’re all on the same page, we want to first quickly review some basics with anal fissures. In brief, this is a condition in which there’s a tear in the sensitive lining of your anal canal.

This damage is often caused by constipation, diarrhea, or anal penetration, and it can lead to moderate to severe pain, especially during and after a bowel movement.

The pain associated with an anal fissure flares with bowel movements because the damage in the tissue often exposes the smooth muscle that makes up your anal sphincter. So, when you try to pass stool, the muscles spasm and pull the fissure apart, which keeps it from healing and causes pain each time you have a bowel movement.

Making matters even worse, his spasm activity can beef up the muscles in your anal canal, which only pulls the fissure wider apart.

Addressing the muscle spasms with a sphincterotomy

One reason we are providing some detail about what happens when you develop a chronic fissure is to illustrate why a sphincterotomy is so successful.

During this procedure, we access your anal canal through your anus, and we make a lateral (side-to-side) incision in your internal anal sphincter. This internal sphincter is beyond your control and works involuntarily during bowel movements.

By relaxing the tension in your internal sphincter, we can prevent painful muscle spasms and increase blood flow to the fissure, promoting healing.

Sphincterotomy procedure and recovery

The good news is that we can perform a sphincterotomy on an outpatient basis and send you home the same day. 

When you get home, plan on taking it easy for a week or two, and you can expect some postoperative discomfort and constipation, which are common in early recovery. We’ll discuss medications and actions to take to offset these side effects.

The good news is that the sphincterotomy boasts an impressive 95% success rate in curing chronic anal fissures, so your patience during recovery is well worth your while.

If you have more questions about whether you’re a good candidate for a sphincterotomy, please click here to set up an appointment at one of our five offices in the Fairfax, Virginia, area.