Patient satisfaction and symptom relief after anal dilatation

Anal dilatation is used as a simple method of treatment and has been used f or both anal fissure and haemorrhoids. This study examined longer-term resu lts among a cohort of 162 patients, 132 of whom responded to a detailed que stionnaire, an 82% response (66 patients were male; age range 17-75 years, median 42 years). Follow-up ranged from 16 months to 36 months (median 27 m onths) after anal dilatation (68 patients for fissure, 32 for haemorrhoids, and 32 for both). In the early months after dilatation, 83% had symptomati c improvement and 76% remained improved. Five (7%) patients with fissure an d 11 with haemorrhoids (17%) required further hospital treatment, while 10% and 17%, respectively, had received further treatment from their general p ractitioners (GPs). Seventy-one percent said they would have a further anal dilation if symptoms recurred. There was no difference in results obtained by surgeons of different seniority. Complications - bleeding (29%) and dif ficulty controlling flatus (15%) or faeces (8%) - resolved in all cases. Th e results of anal dilatation for fissure are generally satisfactory in the longer term, with a trend toward better symptom relief in patients with fis sure compared with those with haemorrhoids. We do not recommend anal dilata tion as the sole treatment of patients with haemorrhoids, but it may be a u seful adjunct to other treatments such as banding or sclerotherapy. Morbidi ty was generally acceptable and the majority of our patients would be prepa red to have this procedure again if their symptoms were to return.