All Fissure Fistula

Can a Fissure Turn into a Fistula?

Two prevalent disorders that affect the anal region and cause discomfort and misery to people are fissure and fistula. Despite their similar sounds, these are two different illnesses with different causes, symptoms, and modes of treatment. There is a link between the two, though, which that raises the question: Is it possible for a fissure to become a fistula? To fully understand this, we need to know more about the traits of these illnesses, how they relate to one another, and their potential causes. As the best proctologist in Delhi NCR, Dr. Ravinder Sharma can offer you a thorough diagnosis and treatment for these ailments. In addition, he may address any query you might have regarding the connection between fissure and fistula.

Understanding Anal Fissure

An anal fissure is a tiny tear or cut in the lining of the anus that is usually brought on by trauma during bowel motions. All ages are affected by this widespread ailment, although adults are more likely to have it. The most common symptom of anal fissure is pain during or after bowel motions. Consequently, bright red blood frequently appears in the stool or on toilet paper. Itching, burning, or discomfort in the anal area are possible additional symptoms.

An anal fissure may occur suddenly or gradually. When given the right care and attention, acute fissure typically heals on their own in a few weeks, but Chronic fissure lasts longer and may require medical care.

Anal Fissure Causes

Anal fissure are caused by several factors:

  • Constipation: One condition that can lead to anal fissure is constipation, which induces straining during bowel movements.
  • Diarrhea: Prolonged diarrhea can irritate the vulnerable anus tissues, increasing the risk of fissure.
  • Trauma: Anal injuries, such as those sustained during childbirth or anal sex, can result in fissure.
  • Inflammatory Bowel Disease (IBD): Because of inflammation and damage to the intestinal lining, conditions including Crohn’s disease and ulcerative colitis can cause anal fissure.

Anal Fissure Treatment

The objectives of anal fissure treatment are to reduce discomfort, encourage healing, and stop recurrence. It might consist of:

  • Dietary changes: Eating more fiber and drinking enough of liquids will soften stool, facilitating easier bowel movements and lessening anorectal strain.
  • Topical medications: lidocaine-containing over-the-counter lotions or ointments/ other soothing ointments help lessen inflammation and pain. 
  • Sitz baths: The sphincter muscles can be relaxed and blood flow to the area enhanced by bathing the anal area several times a day in warm water for 10 to 15 minutes. This aids in the healing process. 
  • Medication: To aid with healing and relaxing the anal sphincter, a fissure specialist doctor may prescribe medications such as calcium channel blockers and nitroglycerin ointments. 
  • Surgical intervention: Injections to paralyse internal sphincter or a lateral internal sphincterotomy are two surgical procedures that may be explored if conservative methods are ineffective in treating persistent fissure. 
  • Kshar Karma Treatment for Fissure: When Fissure-in-Ano is in its acute stage, the recommended course of treatment is Kshar Karma and manual dilation of the sphincter muscles (preferably done by the patient; if it fails to relieve the spasm, then by an expert proctologist). Be extremely careful when performing this procedure to prevent overstretching the sphincter muscles. Kshar Karma is applying Kshar, a specific type of Ayurvedic medication, to the area of the fissure. This medication promotes healing and debrides the fissure.
  • Ksharsutra Treatment for Fissure: When the sentinel tag develops and Fissure-in-Ano has become more chronic, an Ayurvedic proctologist recommends Ksharsutra therapy. The ligation of a specialized medicated thread, called Ksharsutra, at the sentinel tag’s root is the treatment. Within a week or ten days, the sentinel tag sheds as a result of the blood supply being cut off. The patient can go home the same day following treatment since this is an OPD procedure. Typically, the patient can do his regular activities as usual during treatment without the need for hospitalization or bed rest.

Understanding Anal Fistula

An irregular tunnel or route that develops between the skin around the anus and the anal canal is called an anal fistula. It typically arises because of an anal abscess, a pus-filled mass in the tissues around the anus. A fistula may develop from a passage that does not heal properly following an abscess burst or is evacuated.

Anal Fistula Symptoms : 

Anal fistula symptoms might differ in severity and location. Typical signs and symptoms include:

  • Chronic pain in the anus
  • Bulges or swelling close to the anus
  • Blood or pus oozing from the anus aperture
  • Recurrent lesions in the anus
  • Rashes or itching near the anal orifice

Anal fistula causes

An infection in the anal glands, which are tiny glands found inside the anal canal, is usually the cause of anal fistula. These glands have the potential to develop an abscess, which may ultimately result in a fistula if they get clogged or infected. Other elements that raise the possibility of an anal fistula are as follows:

  • Crohn’s disease: People who have Crohn’s disease are more likely to develop anal fistula because of their persistent inflammation and intestinal lining damage.
  • Previous anal surgery: Anal glands or surrounding tissues may sustain unintentional injury from surgical operations like hemorrhoidectomy or fistulotomy, which can result in fistula.
  • Trauma: Anal fistula risk can also be raised by injuries to the anal region, such as those sustained during childbirth or anal intercourse.

Anal Fistula Treatment

The location, degree of complexity, and underlying etiology of anal fistula determine the course of treatment. It may involve:

  • Antibiotics: Antibiotics may be administered to treat an infection if an anal fistula is linked to an abscess or infection.
  • Surgical intervention is used to treat anal fistula. To preserve sphincter function and reduce the chance of recurrence, surgery eliminates the fistula tract along with any related infected or damaged tissue. A variety of surgical methods, including advanced flap repair, fistulotomy, fistulectomy, and seton placement, may be used.
  • Ksharsutra Treatment for Fistula: A medicated thread called Ksharsutra is inserted into the fistula tract as part of this treatment, and it is replaced every week or ten days until the fistula heals fully. This procedure is performed by the Ksharsutra expert. Since this is an OPD treatment, bed rest or hospitalization is typically not necessary for the patient. The patient can go about his everyday activities as usual while receiving treatment. 

Fistula-in-Ano complications such as recurrence or stool incontinence are not observed in the Ksharsutra treatment. 

Can a Fissure Turn into a Fistula?

After discussing the characteristics of anal fissure and fistula, we can now answer the query: Is it possible for a fissure to develop into a fistula? Although anal fissure and fistula are two different disorders, there may be a relationship between them.

Small anal fissures seldom become anal fistula in the absence of any underlying issues. However, the likelihood of complications like abscess and fistula may rise in cases of persistent or untreated fissure, particularly those linked to underlying diseases like Crohn’s disease. Anal tissue damage and chronic inflammation can delay recovery and put people at risk for fistula.

Surgical procedures like lateral internal sphincterotomy for chronic anal fissure can also enhance the chances of the development of fistula. This emphasizes how crucial it is to properly assess and treat anal fissure to avoid complications and encourage healing. 


There may be a relationship between anal fissure and fistula, even though they are treated and caused differently. Anal fistula risk may be raised by untreated or chronic fissure, as well as by some underlying medical disorders. Adequate diagnosis, treatment, and aftercare are critical for the proper management of both disorders and the avoidance of complications. If you have symptoms of an anal fissure or fistula, it is highly recommended that you consult the best fistula doctor in Delhi NCR for an evaluation and appropriate treatment.

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