Ileal pouch anal anastomosis (IPAA) or commonly known as J-pouch is a type of surgery which is done in the digestive system. Due to selective diseases, the colon and rectum are removed and the end of the small intestine or ileum is formed into a J-pouch and connected into the anus. So the wastes from the small intestines flow into the J-pouch and are stored until defecation. During the procedure, the anal sphincters are left intact and untouched so the patient will feel the same urge to defecate just like before the operation.
J pouch surgery is done to patients who suffers from ulcerative colitis, selected cases of Crohn’s disease, familial adenomatous polyposis, colon cancer and toxic megacolon. In Crohn’s disease, cases are extensively reviewed before coming up to a conclusion of whether to or not to perform J pouch surgery. It is allowed if the case of Crohn’s disease affects either the colon and rectum or both.
Now in relation to anal fissures, J-pouch surgery does not intend to cure anal fissures because its main target is to treat inflammation and disorders of the colon and rectum. But if we look closely into the diseases where J pouch surgery is recommended, almost all of the diseases shows symptoms of diarrhea and constipation which are common causes of anal fissures.
Although not intended to treat anal fissures, J-pouch surgery patients get rid of anal fissures as an adverse effect of the surgery.
Laser surgery, on the other hand, is done to correct various health conditions such as hemorrhoid, anal warts, anal fistula, pilonidal cyst and anal fissures. For anal fissure condition, laser surgery is only recommended for chronic cases.
Chronic anal fissures is a tear in the anus that lasts for more than three weeks and is not self-limiting. It causes painful defecation, bleeds during elimination, and leaves a stinging feeling and itching.
Over the course of time, when anal fissure is left untreated, a tag of skin grows around the tear which may grow visibly larger thus increasing discomfort to the patient.
Patients with anal fissures tend to voluntarily contract their anal muscles so the sphincter will gradually release feces. But instead of comforting themselves, this coping strategy worsen the condition and promotes involuntary spasms in the inner anal sphincter muscles.
Anal fissures may lead to the development of internal hemorrhoids and anal fistula. It is highly recommended to consult a doctor upon detection because anal fissures less than six weeks old is still treatable with topical solutions and management. This means fewer expenses and less agony.
Rectal laser surgery is an efficient way of treating anal fissures. The procedure time is less than 5 minutes and is done without incisions and stitches. The surgery is done with local anesthesia but without the need for extensive post-operative care.
Rectal laser surgery is often done with laser ablation on the internal hemorrhoids blood supply to make sure that the anal canal will revive its normal state and prevents the re-development of anal fissures and complications.
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