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{"id":488,"date":"2020-04-08T22:46:57","date_gmt":"2020-04-08T20:46:57","guid":{"rendered":"https:\/\/www.medreport.at\/?p=488"},"modified":"2020-04-08T22:49:00","modified_gmt":"2020-04-08T20:49:00","slug":"hinten-brennts-die-analfissur","status":"publish","type":"post","link":"https:\/\/www.medreport.at\/hinten-brennts-die-analfissur\/juergen-cech\/","title":{"rendered":"Hinten brennt`s. Die Analfissur"},"content":{"rendered":"\n<p class=\"has-drop-cap dropcapp3\">Wenn am After Beschwerden auftreten, werden sie meist <a href=\"http:\/\/www.darmgesund-graz.at\/2017\/08\/23\/haemorrhoiden-wenns-hinten-juckt-und-beisst\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"H\u00e4morrhoiden (\u00f6ffnet in neuem Tab)\">H\u00e4morrhoiden<\/a> zugeschrieben. <a href=\"http:\/\/www.darmgesund-graz.at\/2017\/08\/23\/haemorrhoiden-wenns-hinten-juckt-und-beisst\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"H\u00e4morrhoiden  (\u00f6ffnet in neuem Tab)\">H\u00e4morrhoiden <\/a>sind jedoch ein eher schmerzloses Ph\u00e4nomen, daher lohnt es sich in jedem Fall einen Proktologen Ihres Vertrauens aufzusuchen, um nach einer gezielten Untersuchung, eine gesicherte Diagnose zu stellen entsprechende Therapie festzulegen.<\/p>\n\n\n\n<p>Bei der Analfissur steht ein mit dem Stuhlgang auftretender stechender, scharfer Schmerz, der mehrere Minuten anh\u00e4lt und dann in stundenlanges Brennen \u00fcbergeht im Vordergrund. Sehr oft findet man Blut am Stuhl oder auf dem Toilettenpapier.&nbsp; St\u00e4rkere Blutungen k\u00f6nnen mitunter auftreten. Bei einem chronischen Verlauf kommen N\u00e4ssen und Juckreiz im Analbereich hinzu.&nbsp; Ein typisches Zeichen stellt &nbsp;der schmerzbedingt hohe Sphinktertonus (Muskelspannung des Schliessmuskels) dar, der das Absetzen des Stuhls erschwert und durch das Brennen danach noch zunimmt. In der Folge kommt es zu&nbsp; einer Verschlimmerung der Symptomatik&nbsp; mit einem immer tiefer werdenden Einriss.<\/p>\n\n\n\n<p>Es gibt verschiedene Ursachen f\u00fcr die Entstehung einer Analfissur:<\/p>\n\n\n\n<ul><li>Verletzung des Epithels durch mechanische Sch\u00e4digungen wie z.B. mit hartem Stuhl bei Verstopfung ( \u00dcberdehnung des Anoderms), bei Durchfall (Im Rahmen eines gastrointestinalen Infektes und bei Darmlavagen) oder durch Manipulationen;<\/li><li>Spastik des Schlie\u00dfmuskels (Sphinkter) meist stressbedingtmit folglich schlechter Durchblutung der Analschleimhaut ;<\/li><li>lokale Infektionen mit daraus hervorgehender Irritation des Schliessmuskels;<\/li><li>bestehende neuromuskul\u00e4re Fehlregulationen, die einen erh\u00f6hten Spannungszustand des Schlie\u00dfmuskels bedingen.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1024\" height=\"794\" src=\"https:\/\/www.medreport.at\/wp-content\/uploads\/2020\/04\/dr_juregen_cech_analfisur_timelinie-1024x794-1.png\" alt=\"\" class=\"wp-image-490\" srcset=\"https:\/\/www.medreport.at\/wp-content\/uploads\/2020\/04\/dr_juregen_cech_analfisur_timelinie-1024x794-1.png 1024w, https:\/\/www.medreport.at\/wp-content\/uploads\/2020\/04\/dr_juregen_cech_analfisur_timelinie-1024x794-1-300x233.png 300w, https:\/\/www.medreport.at\/wp-content\/uploads\/2020\/04\/dr_juregen_cech_analfisur_timelinie-1024x794-1-768x596.png 768w, https:\/\/www.medreport.at\/wp-content\/uploads\/2020\/04\/dr_juregen_cech_analfisur_timelinie-1024x794-1-696x540.png 696w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p>Auch chronisch entz\u00fcndliche Darmerkrankungen (z.B. Morbus Crohn, Colitis ulcerosa) oder Infektionserkrankungen k\u00f6nnen zu einer Analfissur f\u00fchren (sekund\u00e4re Analfissur).<\/p>\n\n\n\n<p><strong>Konservative Therapie<\/strong><\/p>\n\n\n\n<ul><li>Stuhlregulierung: F\u00fcr eine normale Stuhlkonsistenz sollte gesorgt werden;<\/li><li>Schmerzenreduzieren:&nbsp; lokal an\u00e4sthetisch wirksame Substanzen&nbsp; (Lidocain-hydrochlorid), GTN (Glyceryltrinitrat)<\/li><li>Verbesserung des anodermalen Blutflusses bzw. sphinkterspasmus :\n<ul>\n<li>Mechanische Dehnung des Sphinkterapparates mit speziellen Analdilatatoren in Verbindung mit entspannenden Massnahmen<\/li>\n<li>Chemische Sphinkterotomie mit Glyceroltrinitrat Suppositorien ( Z\u00e4pfchen) in Kombination mit ISDN und Diltiazem oder Botox;<\/li>\n<\/ul>\n<\/li><\/ul>\n\n\n\n<p><strong>Chirurgische Therapie: <\/strong><\/p>\n\n\n\n<ul><li>Fissurektomie nach Gabriel: Lokales Ausschneiden des Ulkus\/der narbigen Ver\u00e4nderungen unter Mitnahme von Begleitver\u00e4nderungen (Analpapille, Vorpostenfalte) und unter Schonung des Sphinkterapparates<\/li><li>Laterale Sphinkterotomie (seitliche Durchtrennung des Musculus sphincter ani internus): &nbsp;Reduzierter Sphinktertonus \u2192 Abheilung der Fissur<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Wenn am After Beschwerden auftreten, werden sie meist H\u00e4morrhoiden zugeschrieben. H\u00e4morrhoiden sind jedoch ein eher schmerzloses Ph\u00e4nomen, daher lohnt es sich in jedem Fall einen Proktologen Ihres Vertrauens aufzusuchen, um nach einer gezielten Untersuchung, eine gesicherte Diagnose zu stellen entsprechende Therapie festzulegen. Bei der Analfissur steht ein mit dem Stuhlgang auftretender stechender, scharfer Schmerz, der [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":489,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[157,169,87,156,121],"tags":[243,247,119,216,245],"_links":{"self":[{"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/posts\/488"}],"collection":[{"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/comments?post=488"}],"version-history":[{"count":2,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/posts\/488\/revisions"}],"predecessor-version":[{"id":492,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/posts\/488\/revisions\/492"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/media\/489"}],"wp:attachment":[{"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/media?parent=488"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/categories?post=488"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medreport.at\/wp-json\/wp\/v2\/tags?post=488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}