Assessment of thyroid profile in patients with fissure in ano in the South Indian population

Abstract

Background: Hard faeces result in local trauma to the rectal mucosa which secondarily activates internal anal sphincter hypertonia. This will compress end arteries of the anus and cause ischemia of the posterior commissure and eventually anal fissures. A precipitating history of constipation is found in approximately 20% of patients with anal fissures. Constipation is one of the classic signs of hypothyroidism.Methods: Patients who presented to the surgical OPD of Saveetha Medical College and Hospital, Thandalam, India during the months of March and April of 2019 with lower abdominal complaints were screened for fissure in ano. The thyroid profile of these patients was analysed.Results: 38.2% of patients with lower gastrointestinal complaints and 3.6% of the total number of patients presenting to the surgical OPD were attributed to an anal fissure. The incidence of hypothyroidism in patients with an anal fissure is 32%. Since the incidence of hypothyroidism in our study is higher than the prevalence of hypothyroidism in the general population as documented by multiple studies in the past, we can conclude that there is a significant association between hypothyroidism and development of anal fissures.Conclusions: By analysing the thyroid profile in patients with anal fissures, we found an association between the two entities. This information can be used to predict and prevent anal fissures in hypothyroid patients.