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An anal fissure AF is a tear in the epithelial lining of the anal canal.

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This is a very common condition, but the choice of treatment is unclear. The use of anal dilators is effective, economic, and safe.

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Massage to anal aim of the study was to compare the efficacy of two conservative treatments, the use of anal dilators or a finger for anal dilatation, in reducing anal pressure and resolving anal fissures. Fifty patients with a clinical diagnosis of AF were randomly assigned to one of the treatments, self-massage of Massage to anal anal sphincter group A, 25 patients or passive dilatation using dilators group B, 25 patients.

All patients were evaluated at baseline, at the end of treatment, and after 12 weeks and 6 months. Pain was measured using a visual analog scale.

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The use of anal self-massage with a finger appears to induce a better resolution of acute anal fissure than do anal dilators, and in a shorter time. The anal fissure is an extremely common proctologic disease, but the choice of the most appropriate therapy is still difficult.

Because of the high rate of recurrence that afflicts conservative therapy and the risk of serious complications, such as bowel incontinence and bleeding that can affect surgical therapy, it is Massage to anal yet possible to determine which the best treatment is. The conservative treatment of anal fissure relies on the observation of hygienic-dietary measures, obtaining Massage to anal regular bowel movement, and the use of muscle relaxants or anesthetics.

The use of nitroglycerine creams or botulinum toxin appears to Massage to anal a palliative treatment, with rapid loss of effectiveness, and it is often poorly tolerated because of unpleasant side effects [ 4 - 8 ].

The use of anal self-massage...

Therefore, our group has developed a new therapeutic approach that involves anal self-massage by Massage to anal patient. The purpose of this study was to evaluate the effectiveness of anal self-massage in the treatment of anal fissure, comparing it to traditional therapy with dilators. Fifty patients suffering from acute anal fissure were enrolled in this prospective randomized study. All patients agreed to be included in the study and gave their signed, informed consent to randomization.

Inclusion criteria were age ranging Massage to anal 18 to 70 years, presence of anal pain during bowel movements, detection of acute posterior anal fissure. Exclusion criteria were concomitant anal pathology anorectal fistulae, abscessesprevious surgery on the pelvic floor, inflammatory bowel disease, and therapy with nitrates.

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The patients were randomized using a number table to treatment with self-massage of the anal sphincter group Massage to anal, 25 Massage to anal or passive dilatation of the anal sphincter using dilators group B, 25 patients. Patients were evaluated before treatment by digital rectal examination performed with the patient in the left lateral position Massage to anal rest and during different times of functional decline and straining.

Patients were also administered a personal questionnaire about their quality of life analyzing the results according to the Agachan-Wexner score [ 13 ]. The intensity of pain was assessed by visual analog scale VAS. At the end of treatment, all patients underwent a clinical revaluation physical examination, rectal examination and interviews with a standardized questionnaire regarding medical history, information on symptoms such as itching, anal pain, anal burning, bleeding, quality of life, and the VAS scale for pain.

Follow up was scheduled at the end of the treatment and at 3 and 6 months.

During follow up, the following variables were taken into account: Descriptive continuous variables are expressed as mean and standard deviation SD. Of the 50 patients enrolled, 27 were women and 23 men, with a mean age of All patients had Massage to anal acute posterior anal fissure. Bowel movements were normal in 34 patients, 12 patients complained of constipation and 4 reported diarrhea.


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