Anal Fissure Treatments

The goals of treatment are:

• To regulate the consistency of the stools.
• Relaxation of the anal sphincter tone.
• To avoid discomfort, bleeding and pain.
• Healing of the fissure.

Treatment of acute fissure

An acute fissure is managed with non-operative treatments and over 90 per cent will heal without surgery. Most acute fissures usually heal in six weeks.

Treatment measures are:

• Bowel habits are improved with a high-fibre diet, fibre supplements, stool softeners, and plenty of fluids are recommended to avoid constipation and promote the passage of soft stools.
• Warm baths for 10-20 minutes several times each day to promote relaxation of the anal muscles.
• Special medicated creams such as lidocaine jelly can be used to control the discomfort.  The cream is to be applied in the anal canal before as well as after defecation.

Treatment of Chronic Fissure

A fissure that fails to respond to the above treatment should be re- examined to determine if a definitive reason exists for lack of healing. Such reasons can include scarring or muscle spasm of the internal anal sphincter muscle. Those which continue to cause pain and/or bleeding require surgical treatment.
Anal sphincter dilatation under anesthesia helps in majority of the cases.

Those, who do not improve with anal dilatation, require a small operation.  A portion of the internal anal sphincter muscle is cut. This decreases the pain and spasm.  Pain disappears within a few days. Complete healing occurs in 3 to 4 weeks.  Chances of recurrence after surgery are less than 10 per cent.

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