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Anal fissures (clinical (history (painful, bright red rectal bleeding),…
Anal fissures
clinical
history
painful
bright red rectal bleeding
examination
DRE difficult due to pain
treatment
acute (<6w)
dietary advice
high fibre
high fluid
bulk-forming laxatives
lubricants
petroleum jelly
topical anaesthetics
chronic (>6w)
as per acute
topical GTN
if GTN not effective --> surgery or botox
definition
longitudinal or elliptical tears of the squamous lining of the distal anal canal
aetiology
risk factors
constipation
IBD
STI
HIV
syphilis
herpes