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Anal Fissure (cont.)

Anal Fissure Medication

Medications for the treatment of anal fissures fall into two groups:

Constipation control

Anal sphincter muscle spasm control

  • Nitroglycerin rectal ointment
  • Botox injections into the internal anal sphincter paralyzes the muscle for up to three months and may be considered if routine treatments don't succeed or if there is intractable pain.

Anal Fissure Surgery

Surgery is another alternative for anal fissures. It is indicated for chronic anal fissures and potentially for acute fissures that don't resolve after a month of aggressive treatment.

Lateral internal sphincterectomy describes the procedure where the thickened internal sphincter muscle is incised to allow it to relax by releasing the tension within the circular muscle, and allowing the fissure to heal. The operation is usually performed under general or spinal anesthesia.

Sometimes, when a chronic fissure is present, the surgeon may elect to excise or cut out the fissure at the same time.

The pain of the anal fissure resolves almost immediately post operatively. Laxatives and stool softeners may be recommended for a few days after surgery. A high fiber diet is a lifelong recommendation to prevent recurrence.

How Can I Prevent from Getting Anal Fissures?

Preventing constipation and the passage of hard bowel movements prevents anal fissures. Maintaining a high fiber diet and drinking plenty of fluid will promote soft bowel movements, and not only prevents anal fissures but also decreases the risk of developing rectal pain.

Will Treatment or Surgery Cure Anal Fissures?

Medical therapy works more than 80% of the time in treating and preventing future anal fissures. If surgery is required, the success rate is often greater than 95% in preventing recurrences.

REFERENCE: Poritz, LS, MD. "Anal Fissure." Medscape. Udpated: Dec 27, 2016.

Medically Reviewed by a Doctor on 9/11/2017
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