by Dr Cranford » 12 Feb 2016, 17:58
I have been treating anal fissures now for over 40 yrs....I wrote a paper called "Anal Fissure Disease: The Cranford Technique" which describes what fissures are, signs/symptoms, and suitable protocols for treatment. I have seen thousands and only by examination can you decide upon what needs to be done in each individual case. If there is no coexisting pathology(sentinel pile of Brodie, hypertrophied anal papilla, severe sphincter spasm etc) there are non-surgical options one may pursue. If there is surrounding pathology then a more aggressive treatment may be necessary. Typical proctologist will recommend LIS(lateral internal sphincterotomy), which at times may be necessary. However, I do the "Cranford Technique" which consists of anal dilation(manual) under local anesthesia and fissurectomy and removal of coexisting perianal/intra-anal pathology(scar tissue, anal papilla). The advantage, and a big one at that, is I do not cut the surrounding internal/external sphincter muscle. The risk with LIS is a condition called "wet anus syndrome" or anal leakage and patients are just told to live with it. If you have questions please refer to the above cited paper, which I wrote or you may go to sandyclinic.com and look under articles and find it there....Dr Steven Cranford....Sandy Blvd Rectal Clinic-Portland....Naturopathic Physician