Causes: Anal fissures can occur due to various factors, including:

• Straining during bowel movements
• Passing hard or large stools
• Chronic diarrhea
• Inflammatory bowel diseases
• Infections such as HIV, tuberculosis, or syphilis

Treatment: Sphincterotomy is a surgical procedure aimed at relieving anal fissure symptoms. Treatment options include:

• Open Technique:
  • An incision is made across the intersphincteric groove to separate and divide the internal sphincter using blunt dissection or scissors.
• Closed Technique:
  • A small incision is made at the intersphincteric groove, and a surgical knife is inserted to divide the internal sphincter.

Procedure: Sphincterotomy is performed under general anesthesia. The steps involved in the procedure are as follows:

• A small incision is made in the anal canal skin to access the anal sphincter muscles.
• The surgeon relaxes the sphincter by making a small cut, allowing the fissure to heal.
• The wound may be left open or sutured, and a dressing is applied to control bleeding.

Post-Procedure Care: After sphincterotomy, patients are advised to:

• Rest and gradually increase activity levels.
• Maintain good hygiene by showering or bathing regularly and patting the anal area dry.
• Stay hydrated and consume a high-fiber diet to prevent constipation.
• Use stool softeners or laxatives if constipation occurs.
• Take warm sitz baths multiple times a day to promote healing and alleviate pain.
• Use a footstool during bowel movements to facilitate easier passage of stool.
• Avoid using fragranced soaps in the anal area to prevent irritation.