title: [Chronic anal fissure--conservative or surgical treatment?].
abstract: Chronic anal fissure is one of the most common anus diseases. The main ailments reported by the sick are: stubborn pain connected with defecation and bleeding. Etiopathogenesis of this disease has not been exactly explained yet. The most important factors are anodermal blood flow disturbances and excessive cramp of internal anal sphincter (IAS). Lateral sphincterotomy is the main way of treatment. However, a very dangerous complication as a stool incontinence may occur. As far as a pharmacological treatment is concerned, nitric oxide donors, calcium channel antagonist and botulinum toxin have been used. In some patients threatened with stool incontinence botulinum toxin may be used as an alternative way of treatment right after surgical treatment. Other ways of conservative treatment seem to be less effective due to the side effects and the frequency of repeating doses. The view on the etiopathogenesis of anal fissure, the ways of surgical treatment and the mechanism of activity of drugs used in the conservative treatment are presented in this paper.
authors.affiliation: Oddziału Chirurgii Ogólnej Szpitala Miejskiego w Jaworznie. rufarpoczta.onet.pl
authors.forename: Artur
authors.initials: A
authors.lastname: Sandelewski
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kozera
authors.forename: Michał
authors.initials: M
authors.lastname: Dyaczyński
authors.forename: Dariusz
authors.initials: D
authors.lastname: Tomsia
mesh_terms: D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002908:Chronic Disease; D005401:Fissure in Ano / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D020030:Nitric Oxide Donors / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D002121:Calcium Channel Blockers; D020030:Nitric Oxide Donors; D001905:Botulinum Toxins