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Atypical anal fissures associated with Crohn's disease or HIV should be approached cautiously. During the process of defecation, partial eversion of the anal canal leads to more tension arising in these areas. Orthopedics Pediatrics Psoriasis Psychiatry Pulmonology. Lisa Susan Poritz, MD; Chief Editor: Constipation usually is caused by the slow movement of stool through the colon. This is indicated when a trial of medical treatment has failed to produce any significant healing of the fissure, which is most commonly manifested as a persistence of pain.
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In an effort to standardize the method of anal dilation, pneumatic balloon dilation PBD has been developed. Colonoscopy is the best method currently available to diagnose, detect, and treat abnormalities within the colon. Thus, attempts at botulinum toxin injection in patients that have already failed other chemical sphincterotomy may be futile. Often, a small amount of a steroid is combined in the anesthetic cream to reduce inflammation.
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