Anal Fissure Surgery in Vadodara | Dr Samir Contractor

Q: What causes anal fissures?

The most common cause is passing a hard or large stool that stretches the anal canal and causes a tear. Chronic constipation (common with low-fibre diets — maida-heavy Indian diets, insufficient vegetables and water) is the primary risk factor. Less commonly, chronic diarrhoea, Crohn's disease, or prior anorectal surgery can cause fissures. In Indian dietary terms: a regular intake of vegetables, dal, whole wheat roti, fruits and 2–3 litres of water daily prevents most fissures.

Q: Can an anal fissure heal without surgery?

Yes — acute fissures (under 6 weeks) often heal with dietary changes (high fibre, lots of water), warm sitz baths and topical creams. However, chronic fissures (over 6 weeks) rarely heal fully without addressing the underlying sphincter spasm, and typically require either botox injection (60–70% success, wears off) or LIS (>95% success, permanent). Most patients with chronic fissure eventually require LIS, so early surgery is often the most practical approach.

About the procedure

What is an anal fissure and how is it treated?

An anal fissure is a small tear or crack in the thin, moist tissue (mucosa) that lines the anus. It causes sharp, burning pain during and after a bowel movement — often described as "passing broken glass" — and may cause bright red bleeding on toilet paper or in the pan. The pain can last minutes to hours after defecation and is frequently the worst pain a patient experiences each day.

Fissures become chronic (lasting more than 6 weeks) when the tear triggers spasm of the internal anal sphincter muscle, which reduces blood flow to the fissure and prevents healing — a self-perpetuating cycle. Chronic fissures have a characteristic appearance: the tear itself, a skin tag (sentinel pile) below it, and a hypertrophied anal papilla above.

Lateral Internal Sphincterotomy (LIS) is the gold-standard surgical treatment for chronic anal fissure. A small, controlled cut in the internal anal sphincter reduces the high resting pressure in the anal canal, restoring blood flow to the fissure, breaking the pain-spasm cycle, and allowing healing. Healing rates exceed 95% and the procedure is performed as a 20-minute day-care operation.

Why trust this content

Experience · Expertise · Authority · Trust

Every page on this site is written and medically reviewed by Dr Samir Contractor — a practising fellowship-trained surgeon — not by a content agency. Here is the evidence behind that claim.

Experience

Over 25 years of continuous surgical practice at Sterling Hospitals, Vadodara. Every claim on this page is drawn from direct clinical experience — not textbook paraphrasing.

25+ years in active surgical practice

8,000+ total procedures performed

5,000+ laparoscopic procedures

400+ bariatric procedures (sleeve & bypass)

1,500+ anorectal procedures

Senior Consultant, Sterling Hospitals since 2000

Expertise

Fellowship-trained at the Royal College of Surgeons of Edinburgh with subspecialty MIS training at Sir Ganga Ram Hospital, New Delhi. Board-certified in multiple countries.

MBBS — Medical College Baroda

MS (General Surgery) — Medical College Baroda

FRCS — Royal College of Surgeons, Edinburgh (UK)

FMAS — Fellow in Minimal Access Surgery

FACS — American College of Surgeons (USA)

PN1 Certified Exercise & Nutrition Coach

Authoritativeness

Affiliated with Sterling Hospitals — a leading multi-specialty hospital in Vadodara. Active member of recognised surgical bodies in India, the United Kingdom and the United States.

Senior Consultant, Sterling Hospitals, Vadodara

Indian Medical Association (IMA)

Indian Assoc. of GI Endo Surgeons (IAGES)

Obesity Surgery Society of India (OSSI)

Association of Surgeons of India (ASI)

General Medical Council, United Kingdom

Trustworthiness

Transparent pricing published on every procedure page. Surgery recommended only when clinically indicated. 4.9★ patient rating from named, verified patient reviews.

★ 4.9 average verified patient rating

Transparent package pricing on all pages

Medical disclaimer on every page

Content last reviewed: May 2026

Sterling Hospitals, Vadodara — established institution

Surgery discussed only when clinically appropriate

Qualifications

MBBS MS — General Surgery FRCS (Edinburgh, UK) FMAS FACS (USA) PN1 Certified

Memberships & Registrations

IMA IAGES ASI OSSI GMC, United Kingdom Royal College of Surgeons, Edinburgh American College of Surgeons

Who needs this procedure

Is this surgery right for you?

A consultation with Dr Samir Contractor is required for a definitive assessment of candidacy.

✓ SUITABLE Typical candidates

Chronic anal fissure (> 6 weeks duration)
Fissure not responding to 6–8 weeks of topical treatment (GTN, diltiazem, botox)
Acute fissure with features of chronicity (sentinel pile, fibrous base)
Severe pain significantly impacting quality of life
Recurrent fissure after conservative treatment
Associated hypertrophied anal papilla requiring excision

✗ DISCUSS FIRST May need alternative approach

Acute fissure (< 6 weeks) — try topical glyceryl trinitrate or diltiazem cream first
Crohn's disease fissure (requires different management)
HIV or immunosuppressed patients (conservative management preferred initially)
Posterior fissure in young women with low sphincter pressure (risk of incontinence)
Fissure with concurrent abscess or fistula (address simultaneously)

Why this treatment

Benefits of the surgical approach

Rapid, dramatic pain relief

Most patients notice a significant reduction in post-defecation pain within days of surgery — often the most immediate relief they have experienced in months.

95%+ healing rate

LIS has the highest success rate of any treatment for chronic anal fissure — well above topical creams (50–70%) or botox injection (60–70%).

Day-care procedure

No overnight hospital stay required. Admitted and discharged on the same day.

Low recurrence rate

Recurrence after successful LIS is rare (under 5%). Maintaining a high-fibre diet and adequate hydration prevents most recurrences.

How it's done

The procedure, step by step

Anaesthesia

Short general or spinal anaesthesia. Total procedure time approximately 20–30 minutes including anaesthesia.

Examination under anaesthesia

With the patient relaxed, the fissure, sentinel pile, hypertrophied papilla and sphincter tone are carefully assessed.

Lateral internal sphincterotomy

A precise incision is made laterally (at the 3 or 9 o'clock position, away from the fissure at the posterior midline). The internal anal sphincter is divided through its lower one-third to two-thirds using a fine scalpel. This is done under direct vision (open LIS) for maximum accuracy and safety.

Fissurectomy (if indicated)

If the fissure base is fibrotic or chronic, the fissure itself may be excised to freshen the wound edges and promote faster healing.

Sentinel pile removal

The external skin tag (sentinel pile) may be excised at the same time if it is causing hygiene problems or discomfort.

Discharge

Dressing applied, patient recovered for 1–2 hours, discharged the same day. Stool softener prescribed for 4–6 weeks.

What to expect

Your recovery timeline

Day 0

Procedure and discharge

Discharged same day. Mild soreness at the small wound site (laterally). Begin stool softener immediately. Light soft meal in the evening.

Days 1–3

Home rest

Significant reduction in pain during bowel movements is noticed quickly. Warm sitz baths 2–3 times daily. Paracetamol for mild discomfort. Increase dietary fibre.

Days 3–5

Return to desk work

Most office workers return to work. Driving is safe. Continue stool softener.

Week 2–4

Progressive healing

Fissure heals progressively. Normal bowel movements without pain. Light gym fine from week 2.

Week 6

Review and full recovery

Follow-up with Dr Samir. Fissure fully healed in >95% of patients. Stool softener may be weaned off.

Transparent pricing

Package rates at Sterling Hospitals, Vadodara

All-inclusive package costs — no hidden charges. Two room categories available. Final confirmation at consultation.

Procedure

Standard Room

Deluxe Room

Fissurectomy / Lateral Internal Sphincterotomy (LIS)

₹39,900

₹62,100

✓ Included

Surgeon fee · Anaesthesia · OT charges · Room rent (2 days) · Doctor visits · Miscellaneous

✗ Billed separately

Labs · Pharmacy · Radiology · Consumables

Packages include surgeon fee, anaesthesia, OT charges, room rent (2 days), doctor visits & miscellaneous. Excludes labs, pharmacy, radiology & consumables. Procedure typically performed as day care.

Confirm package on WhatsApp Call Sterling Hospital

Quick answers

Frequently asked questions about Lateral Internal Sphincterotomy (LIS) for Anal Fissure

How do I know I have an anal fissure and not piles?

Anal fissure causes sharp, burning pain during and after a bowel movement — often lasting 30 minutes to several hours. The pain is the dominant symptom, with only small amounts of bright red bleeding (typically on toilet paper). Piles more commonly cause painless bleeding or a prolapsing mass, with pain only if they thrombose or are very large. A clinical examination — which takes 2 minutes — clearly distinguishes the two conditions.

I've been using ointment for 3 months with no improvement — should I have surgery?

Yes, surgery is appropriate. Current guidelines recommend 6–8 weeks of topical treatment (glyceryl trinitrate or diltiazem cream) as the first step. If the fissure has not healed after 6–8 weeks of consistent topical treatment, LIS is indicated. Prolonged ointment use beyond this point rarely adds benefit and may cause side effects (headache from GTN). LIS has a far higher success rate (>95%) than any topical treatment.

Will surgery affect my ability to control my bowels?

This is the most important concern with LIS, and it is why the procedure must be done carefully by an experienced surgeon. Open LIS with direct visualisation — which is our standard technique — limits the sphincterotomy to the lower one-third of the internal sphincter, well within the safe zone. Minor transient incontinence to flatus (gas) occurs in approximately 5% of patients and resolves. Significant incontinence to stool is extremely rare (< 0.5%) with properly performed LIS in appropriate patients.

What causes anal fissures?

The most common cause is passing a hard or large stool that stretches the anal canal and causes a tear. Chronic constipation (common with low-fibre diets — maida-heavy Indian diets, insufficient vegetables and water) is the primary risk factor. Less commonly, chronic diarrhoea, Crohn's disease, or prior anorectal surgery can cause fissures. In Indian dietary terms: a regular intake of vegetables, dal, whole wheat roti, fruits and 2–3 litres of water daily prevents most fissures.

Can an anal fissure heal without surgery?

Yes — acute fissures (under 6 weeks) often heal with dietary changes (high fibre, lots of water), warm sitz baths and topical creams. However, chronic fissures (over 6 weeks) rarely heal fully without addressing the underlying sphincter spasm, and typically require either botox injection (60–70% success, wears off) or LIS (>95% success, permanent). Most patients with chronic fissure eventually require LIS, so early surgery is often the most practical approach.

Patient outcomes

What patients say after their treatment

I was in agony every morning for over a year. Tried three different ointments from three different doctors — nothing worked. Dr Samir explained why the ointments weren't helping and did the LIS. The difference in pain after just two days was remarkable. Life-changing.

Dipika Rao

Anal fissure · Vadodara

★★★★★

Two years of pain and embarrassment, too scared to have surgery. Dr Samir was patient and detailed in his explanation. 20-minute procedure, home the same day, back at work in four days. Complete pain relief. I only regret not doing it sooner.

Kiran Bhai Modi

Chronic fissure · Baroda

★★★★★

Book a consultation

Meet Dr Samir at Sterling Hospital, Vadodara.

WhatsApp gets the fastest response. For appointment booking by phone, call the Sterling Hospital reception during OPD hours.

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+91 98245 93464

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Appointments — Sterling Hospital

+91 98989 89797

Mon–Sat, 9:00 AM – 8:00 PM IST.

Clinic

Sterling Hospital, Opp. Inox Cinema
Race Course Circle (W), Vadodara – 390007

OPD: Monday–Saturday, 10:00 AM – 7:00 PM

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Dr Samir Contractor

MS FRCS (UK) FMAS FACS (USA) PN1

Sterling Hospitals, Vadodara 25+ years · 8,000+ surgeries ★ 4.9 rating