¿Cuál es el tratamiento de primera línea de la fisura anal?
El manejo de primera línea de la fisura anal es conservador. El enfoque aborda tanto el malestar inmediato del dolor agudo como el patrón defecatorio subyacente que promueve la formación de la fisura e impide su cicatrización.
Objetivo del tratamiento
Consistencia de heces blanda que se evacúe sin esfuerzo.
References
DOI: 10.1111/codi.167
- Patients should be encouraged to aim for stool consistency which is soft and passed without straining.
- This can be achieved using a combination of lifestyle measures (increased physical activity, weight loss, if appropriate, and adequate hydration), dietary changes (at least 30 g of fibre per day) and laxatives.
- This can be in the form of acute sharp pain which may be treated with topical anaesthetic agents such as lidocaine.
- In addition, patients may also experience a burning, dull perianal discomfort which may last for several hours after defaecation and may be offered nonopioid analgesics such as paracetamol with further escalation as appropriate.
- Advice includes not ignoring the urge to defaecate and avoiding prolonged sitting on the toilet or straining.