In the formation of the cracked anal passage, the increase in the tone of the anal sphincter plays a certain role. Moreover, its persistent spasm prevents the wound healing and sharply reduces the chances of recovery. Today, effective conservative treatment of anal crack is impossible without using nitroglycerin cream from anal cracks, relaxing rear passage.
Content
The reasons for the formation of cracks of the anal pass are studied quite deeply, but there is no consensus on this issue yet. Anyway, the factor in the presence of constipation is considered one of the main in the mechanism of wound formation. Rare, less than 3 times a week, a chair, accompanied by the passage of a dense communal feces through the bottom Department of the rectum, leads to the skin injury and the formation of an acute cracker of the rear passage. The development of the disease contributes to the spasm of anal sphincter, even more imperative intestinal emptying.
Prevention of constipation in conservative treatment of anal crack
Fighting constipation — The main direction of therapy of the anal crack. A complex of medical measures includes the appointment of a special gentle diet with a high content of vegetable fibers, stimulating intestinal peristalsis and preventing stool delay. Extras are appointed light laxatives, oil enemas, candles and creams from anal cracks. In 80-90% of patients, similar therapy brings their fruits, and the crack of the anal passage will safely heal. In the rest, it is transformed into a chronic form, and the treatment of chronic anal cracks with the help of diet, laxatives and candles is rarely ineffective, because not even constipation plays crucial importance in its existence, and the spasm of the sphincter of the rear pass.
Expansion of anus in the treatment of chronic anal crack
Effective treatment of anal crack is impossible without elimination of the spam of anal sphincter. Excessive abbreviation of the muscle locking anal move, leads not only to the difficulty of defecation and constant irritation of the anal wound, but also contributes to the violation of blood circulation in the tissues of the rectum, slows down the course of reparative processes and prevents recovery.
Spasm sphincter enhances pain during and after the intestinal emptying, severe pain leads to the formation of a fear of the chairs. The intentional latency of the chair becomes the cause of the strengthening of constipation and the lack of effect from the conservative therapy of the anal crack.
More recently, the treatment of chronic anal crack was widely used mechanical divoles anus, that is, its violent expansion. In this development, special extenders or doctors' fingers were used. The purpose of such an execution was to achieve a resistant reduction in the tone of the sphincter of the rear pass. The crack after expanding anal passage really heal more actively, but the lack of method was its initial increase during the procedure and the formation of new gaps of mucosa and skin around the anus circle. Moreover, half of the sick cracks recurred during the year, the part did not have a resistant redundancy of the tone of the locking thorough, incontinence of gases and liquid stool.
Today, the expansion of the anus is almost not carried out, there are more efficient methods. Effective therapy of the anal crack today is impossible without drug dilatation of the sphincter, and nitroglycerin cream from anal cracks is the main drug for these purposes.
Conservative «Medical Sphincterotomy» in the treatment of anal crack
Medical Sphincterotomy — This is an alternative to surgical treatment implying partial dissection of the beams of the locking muscle in order to reduce its tone. First row preparations for effective treatment of anal crack become nitrates that have a pronounced relaxing effect on the smooth muscles of internal organs and vessels. Nitrates are known as medicines for cardiovascular therapy, in particular, all familiar nitroglycerin is used to relocate attacks and treatment of angina. Treatment of chronic and recurrent anal cracks using nitrates can significantly reduce pain accompanying disease, and in 50% of cases abandon operational interference in favor of conservative therapy.
For the treatment of cracks of the rear pass today, nitroglycerin cream 0.2% and 0.5% concentrations are used. These forms from the anal cracks are equally effective and have similar side effects in the form of periodic headaches caused by the expansion of brain vessels, and quickly by ordinary analgesics.
Approximately 5 minutes after the application of nitroglycerin ointment, pain in the area of the rear pass is significantly reduced, defecation is facilitated. The use of means 2-3 times a day for 4-6 weeks in half cases leads to anal fissure healing. The early termination of therapy due to chronic headaches, dizziness, tachycardia leads to a relapse of the disease and forces to resort to other methods of treatment and operation.
