Anal fissure - is damage to the tissue covering the inside of the anus. In most cases, it is quickly cured, but sometimes it becomes a chronic disorder.

Symptoms

Symptoms of an anal fissure are:

• Pain during bowel movements;
• Pain after defecation, which can last a few hours;
• Bright red blood in the stool or on the toilet paper after a bowel movement;
• Burning or itching in the anus;
• Visible cracks in the skin of the anus;
• Small seal on the skin around the anus.

Causes

The most common cause of anal fissure include:

• Frequent constipation and / or stress during defecation;
• Chronic diarrhea;
• Inflammation in the anus and rectum caused by Crohn's disease or other inflammatory bowel disease Inflammatory Bowel Disease: Symptoms and Treatment .

Much less often causes formation of anal fissures can be:

• Anal sex;
• Cancer;
• HIV;
• Tuberculosis;
• Syphilis.

Risk factors

Factors that increase the likelihood of anal fissure:

• Infancy. Many children in the first year of life are formed anal fissures; experts do not know what causes it.
• Aging. In elderly people the fissures may be formed due to slow blood flow, which reduces blood flow to the colon.
• Constipation. Hard stool increases the probability of rupture of the tissues of the anus.
• Childbirth. Anal fissures often occur in new mothers.
• Crohn's Disease. The disease causes a chronic inflammation in the intestine, which makes anal passage more vulnerable to various injuries.

Complications

Anal fissure can cause the following complications:

• Recurrent anal fissure. If it is a violation of a person once developed, there is a high probability of relapse.
• Chronic anal fissure. If anal fissure does not heal within six weeks or more, the violation becomes chronic.
• Distribution of the gap to the adjacent muscles. Anal fissure can spread to the muscular ring (internal anal sphincter), which keeps the anus closed. Because of this anal fissure heals more slowly and causes discomfort.

Diagnostics

For the diagnosis of anal fissure is usually sufficient to study the history and examination of the anus. Sometimes the doctor also conducts a rectal examination. If the doctor suggests that the symptoms for which the patient complains, caused by another disorder, it may appoint an additional examination, eg, sigmoidoscopy, anal manometry and / or colonoscopy Preparing and conducting a colonoscopy: the risks and alternatives .

Treatment

Most often, for the treatment of anal fissure using non-surgical methods. Thus, a patient can be assigned supplementation Food additives - basic classification   a dietary fiber. Fiber prevents constipation and prevent thus further irritation of anal fissure.

For the treatment of anal fissures can also be recommended the use of nitroglycerin ointment. This ointment enhances blood vessels in the anus and improves thus, blood flow to the anal fissure, and it accelerates healing. Nitroglycerin ointment also helps to reduce the pressure in the anal sphincter, relieve cramps and pain. Side effects of this ointment can be headaches, low blood pressure and dizziness Dizziness - if the ground is slipping from under his feet . The ointment should be applied in disposable rubber gloves. For some time after application of the ointment is desirable to avoid strenuous physical activity. Men should not use nitroglycerin ointment within days after taking any medications for treating erectile dysfunction.

Sometimes, to relieve spasms injected Botox into the anal sphincter. A side effect of this treatment can be a temporary fecal incontinence.

In addition, for the treatment of anal fissure is sometimes recommended intake of calcium channel blockers.

In chronic anal fissure can be treated by surgical methods recommended. During the operation, a small portion of the anal sphincter is cut to relieve spasms and pain and accelerate healing.

Direct prostate massage is performed only urologist or a specially trained nurse such a massage. Layman trusted to conduct direct prostate massage is impossible - it is not only not improve the patient's condition, but it can aggravate it. It is also impossible to carry out a self-massage.

What is direct massage of the prostate and what it is spent

Prostate male (prostate) is located just below the bladder Urinary bladder - structure and function   and covers the upper part of the urethra. Therefore, any disease of the prostate, accompanied by her swelling or growth of tissue, causing urination disorders. Pain is also characteristic of the disease of the prostate, as in the region where it is located, is a lot of nerve plexus.

To remove the swelling and inflammation of the prostate tissue is recommended to perform the massage. The most effective is the direct prostate massage Prostate massage - a shameful procedure?   thumb through the wall of the rectum. However, prostate disease can be different, and not at all helpful to conduct a massage. Therefore, prior to direct prostate massage is usually examine a patient.

Direct prostate massage is performed in chronic inflammatory processes in the prostate (chronic prostatitis), but when it is contraindicated in acute processes. The fact is that massage causes dilation of blood vessels and blood flow to the prostate. In chronic prostatitis with subacute inflammatory process is useful because it improves metabolism, stimulates the gland and its deliverance from the inflammatory process, contributes to a better absorption of other drugs.

But in case of acute inflammatory processes, when the inflammation is a lot of infectious agents and inflammatory products, massage is dangerous because all these elements fall into the dilated blood vessels and smash it around the patient's body, causing foci of inflammation in various organs and tissues. This can lead to sepsis - a serious condition that requires urgent medical care in hospital.

It is impossible to massage and prostate cancer - it can stimulate tumor growth and the emergence of metastases.

How to conduct direct prostate massage

Direct prostate massage is performed after inspection and establishing a definitive diagnosis to be sure that the procedure does not harm the patient. Prostate massage is performed in a doctor's office urologist. It is also possible the behavior of direct prostate massage urological nurse's office, which has a special training on the issue.

The patient must clearly understand all the features and benefits of massage of the urethra, this urologist before the appointment procedures always explain what is happening in the body as a result of such exposure. Only in this case the patient will try as much as possible to fulfill all the requirements of a doctor with a massage.

First of all, the patient must learn to relax in a certain position. It's not as easy as it seems, because many men find massage humiliating procedure and it does not allow them to relax. If you make yourself relax fails, then holding massage is delayed and patients received special medicines with a soothing and relaxing effect of the muscles (usually tranquilizers, such as seduksen).

Carrying forward the procedure prostate massage should be completely painless - a specialist who owns the massage technique, it can achieve this. Painful prostate massage will not bring benefit to the patient.

How is the procedure of direct prostate massage

The patient is placed on a couch on the right side or in a knee-elbow position. The doctor puts on rubber gloves, lubricates the index finger with Vaseline Vaseline: old friend   and enters it into the rectum, feeling the prostate gland. After determining the size and consistency of the prostate gland (it is made sure before each treatment) made a direct impact on its fabric along the ducts, stimulating the secretion elimination.

First, the right lobe is stroking is performed in the direction from the gland upper outer edge towards the center (to the midline). Then, the same have a direct impact on the left lobe of the prostate. In the first two massage stroking limited. Unless there was a worsening of the disease, prostate swelling and tenderness, then the third session attached to the stroking pressure on the prostate gland. Total spent about 10 sessions (their number determined by the physician) at intervals of once every two days.

Direct prostate massage - a wonderful method of treatment of chronic prostatitis Chronic prostatitis - every man should know his signs Which can be combined with medication.

Galina Romanenko