When the skin of the anus gets cut or damaged, that is called an anal fissure. It is very similar to what happens when our dry lips get chaffed. Fissures typically bleed and cause pain, which is why they are often confused with haemorrhoids/ piles. When the anal muscles are stretched too far, it usually causes strain on the anus. This can occur to people who suffer from constipation or prolonged diarrhoea. It also occurs for older patients due to decreased blood flow to the anal area. It is not uncommon for women to develop anal fissures after giving birth as well. And it can also happen to people who have Crohn’s disease. With more severe cases of anus tearing, an external lump will form on the anus. These are the sentinel piles tell-tale of chronic fissures. The issue of anal fissures can be solved by medicine or by surgery and also by laparoscopic treatment. Symptoms Some signs and symptoms of anal fissures : Pain during bowel movement Pain after the bowel movements Blood on the stool or toilet paper Anal itching Visible damage to the skin of the anus A small lump that’s close to the anal fissure. Treatments Chemical Sphincterotomy Chemical Sphincterotomy is basically a Botox Injection for anal fissures; it is a very common Treatment for Anal Fissures. If the anal fissure doesn’t heal, it’s usually because of the spasm of the internal anal sphincter muscle which reduces blood supply to that area and further aggravation occurs to the fissure during the passage of motion through a spasmodic anal canal. The Botox is injected into the anal sphincter. This injection is used to prevent spasm and cause temporary paralytic relaxation until the tissues are renewed. The effects last for three months and the anal fissure heals during that time. Percutaneous Closed Lateral Internal Sphincterotomy This surgery, popularly known as CLIS, is a quick minimal invasive surgical method performed by specialized doctors under local anaesthesia that is used to treat chronic anal fissures. It is performed on the internal part of the anal muscle, the internal anal sphincter. The surgical procedure basically lowers the pressure of the internal anal sphincter and the spasm is reduced by dividing this internal anal sphincter. The fissure is healed because anal spasm is lowered and blood flow to the area is improved. Due to the closed technique, the wound is smaller and it heals faster.

Umbilical hernia is a bulge form in abdomen. In children, it is healed on its own but if this disease occurs in adults then a surgery is needed. The surgery of Umbilical hernia is done by laparoscopic surgery and is less risky. Symptoms: Umbilical hernia is called so because these types of hernia are present near the umbilicus area or the naval area of the abdomen. When occurred in children of around 2 to 3 years, it can be seen that it heals on their own. The common symptom of this type of hernia is discomfort and severe pain. Patient suffering from umbilical hernia have severe pain and have a bulge in near the naval area. They have difficulty in lifting things. Diagnosis of Umbilical Hernia: Physical examination is done. The doctor will see if the hernia can be reduced. Further diagnosis is done with the help of X-ray and ultrasound. Treatment and Recovery: Surgeon does an incision at the naval area of the abdomen where the bulge is present. They push the tissue back inside the stomach wall. Time taken for surgery is approximately an hour. The recovery is fast as the approach used here is laparoscopic approach.

Appendicitis is the swelling of the appendix which is present in the right side of the abdominal region. It is generally a 5-10 cm tube connected to the large intestine. If it is not treated at the right time it can burst out, spilling infection in the abdominal cavity that can be more fatal. Appendicitis can occur anytime between the age of 10 to 30. Both men and women can suffer from this condition. The infectious material or the puss which is formed inside the appendix can be more dangerous to life as it spreads in the entire abdominal cavity. Patient suffering from appendicitis ignore this because it seems like a common stomach pain. There are many causes that can cause appendicitis out of which one common cause is the blockage or obstruction in appendix. Obstruction can cause due to the bacteria multiply inside the organ causing the increase in the infection inside the appendix forming a puss. Symptoms: Patient suffering from appendicitis commonly have a pain in the right side of the abdomen. A raise temperature, means, they may feel that they are having fever. Nausea and vomiting, other symptoms includes abdominal swelling, inability to pass wind, painful urination. Dr Jiten Chowdhry notes that these treatments can cause appendix to burst if the patient is suffering from appendicitis. If you have tenderness in the right side of the consult a doctor. Diagnosis: Abdominal examination is done to detect the inflammation. A urine test is done. Rectal examination, CT scan and blood test is done to diagnose the appendicitis condition properly. Treatment and Recovery: Laparoscopic surgery is performed where a small incision is done in the lower right side. The recovery time is very short and the patient can get discharged within 3 to 4 days of the surgery.

Hernias will not go away by themselves. Surgery is the only way to repair a hernia. A hernia repair returns the organ or structure to its proper place and fixes the weakened area of muscle or tissue. Having surgery is a big decision. It can be tempting to put it off, and that may be okay in some cases. Before you decide, make sure you understand the risks and benefits of your decision. Here are some things to consider and discuss with the doctor who is helping you make the decision. How Is the Hernia Affecting You? The first thing to consider is whether or not you are experiencing symptoms. Not everyone has symptoms with a hernia, especially small ones. When symptoms occur, the most common one is pain. Others can include a feeling of heaviness or fullness in the belly or groin. Whether you have symptoms or not, a hernia can also interfere with your leisure activities and your work. So you also need to recognize if you are taking time off from work or interests due to your hernia. Delaying surgery may mean you spend more time away from work and fun instead of returning to activities after recovery. If you have symptoms, especially pain, your doctor is likely to recommend surgery. But what if you don’t have symptoms or they are minimal? In this case, your doctor may recommend watchful waiting. Before you agree to watchful waiting, be sure your doctor knows the whole story. Be honest about any limitations your hernia puts on your time and activities. What Are the Risks of Waiting? 1. Hernias can become incarcerated. One potentially serious risk of not fixing a hernia is that it can become trapped outside the abdominal wall—or incarcerated. This can cut off the blood supply to the hernia and obstruct the bowel, resulting in a strangulated hernia. This requires urgent surgical repair. Not all hernias progress to this point, but it is a risk nonetheless. Avoiding an emergency situation that you can’t control is one reason to consider not delaying surgery. 2. Hernias grow. A more likely scenario is that your hernia will continue to grow and weaken with time. This is likely to increase your symptoms, including pain, and cause more changes to your lifestyle. Surgeons know that smaller hernias are easier to repair than larger hernias. Going ahead with surgery instead of delaying it can prevent your symptoms from getting worse. It can also help you avoid losing work or missing activities. 3. Hernias require surgery eventually. Even if you aren’t having symptoms, you may still want to consider having surgery sooner rather than later. Surgery for a hernia is somewhat inevitable in most cases. Research shows that most people with hernias have surgery within 10 years. Keep in mind that delaying surgery until your hernia is larger and the muscles are weaker may make surgery and recovery more difficult. 4. Your overall health may change. Your age may determine whether waiting is a risk for you. Putting off surgery for years down the road may mean you are not in as good overall health or physical shape. This will also affect your surgery and recovery. So having surgery at a younger age can be beneficial. However, if you are elderly (older than about 75 years of age), not very active, and your hernia isn’t causing problems, it may be better to not fix it. The risks of surgery may outweigh the benefit of repair. Making the Decision Surgery is never convenient and life is always busy. Being in control of when you have surgery is a huge benefit of not delaying your hernia repair. You can schedule your surgery at your convenience. And if you are a candidate for laparoscopic hernia surgery, you’ll be back to life and work sooner than in years past. Surgery should be easier on you and recovery will likely be smoother at a younger age and with a smaller hernia. Ultimately, your doctor is best able to help you decide whether watchful waiting or surgery is the best option for you.