The patient describes the rectal fissure from 11/14, the patient treated in the place of the permanent residence with the short-term improvement, Proktils N, ung. (the pains and pruritus during defecation), the occasional obstipation, she takes the dietary fibre.
The objective examination: per rectum: the anal surroundings without the present irritation, the anoderm is more dry, in the perianal region – the isolated condyl. accuminatum (in 5 hrs.) the indagation is free, she slightly feels the hypertrophic sphincter, otherwise without the pathological finding.
The anoscopic examination: I do not observe the objective fissure, the scar after the healed fissure in the posterior commisura, v.n.h up to gr.I without the irritation, no conylomata are present. The recommendation: autodilatation, (dosp.an.), the patient is instructed, the soaps must be excluded from the anal hygiene, the local application: Ambiderman ung., she will take care about the defecation act.
