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AfrAXX01(Black patient)- "Multiple fissures at the anus are common with untreated HIV disease. These fissures are NOT like the Western fissure with anal spasm, and so do not respond to anal stretch (a disaster), GTN or nifedipine cream.  If extensive, and with complex fistulae, it is probably best to make a defunctioning colostomy.  Check for TB or syphilis, which may also be present. (With HIV there is often more than one pathology)." (Dr. Catton)

See "4-anal area"




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