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ANAL FISSURE; PREVALENCE, CAUSES, RISK FACTORS AND TREATMENT MODALITIES IN THE EASTERN AREA OF SAUDI ARABIA

Mohammed Abdullatif Alomair , Malik Azhar Hussain , Noor Nahar Bumarah , Amal Basheer Al Obaid , Haidar Alameer , Mohammad Abdullah Alutaibi , Omar Mohamed Bakr Ali , Sarah Jamal Alkhannani , Saja Jamal Alkhannani

Anal fissure causes severe pain and bleeding with bowel movements, and is associated with spasm of the internal anal sphincter which may lead to delayed healing. It is a common clinical problem, and the incidence varies substantially by age and sex. Objectives: to investigate the prevalence of anal fissure and its manifestations and causes among young general population of Eastern Governorate in KSA. Methods: This is across sectional study was conducted among 372 of studied population, during the period from 1 March to 31 July, 2018. Data collected using a pre-designed online questionnaire. Results: the prevalence of anal fissure among the studied participants was 31.9%, it was more prevalent among males (54.6%) than females (P= 0.03). However, there was no significant correlations with age (P= 0.244) and it was mostly found among the age group 22-40 years. Symptoms included severe pain during and after defecation in 47.1%, anal itching in 36.1%, anal bleeding especially after defecation in 35.3% and only 9.2% reported blood tinged secretions accompanied by foul odor. As regards the causes of anal fissure, we found that the most common cause was chronic constipation by 32.8% followed by anal itching 12.6%, chronic dysentery and pregnancy reported by 5.9% for each of them, Crohn's disease in 3.4% and anal fistula in 1.7%. Transformation of the fissure from acute to chronic was the most common complication (15.1%) followed by anal fistula in 13.4%, narrow anus due to scar formation in 12.6%. Regarding the treatment of anal fissure, herbal remedies was the most common method for treatment used by 53.8%, followed by laxatives, analgesics in 24.4% and topical ointments 21.8%. Improvement was found in only 47.9%. Conclusion: AF is a common clinical problem, more common in males. Constipation is the most commonly associated comorbidity. herbal remedies was the most common method for treatment followed by laxatives, topical ointments, analgesics and topical ointments. Keywords: Anal fissure, Risk factors, Causes, Treatment.

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