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Treatment for chronic anal fissure

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Anal fissures in most cases heal within a few days to a week. But for some, the pain, cut and tear in the anus either remain for a long term or tend to recur very frequently. Such cases are referred to as chronic anal fissures as they last for a month or two or more. Chronic anal fissures do not health with home remedies and they require medication or surgery.

We shall explain the treatment choice below:

Glyceryl trinitrate (GTN) rectal ointment

GTN is an ointment that works by increasing the diameter of the blood vessels surrounding the anus. Due to increased area, blood circulation in the anus increases, which further promotes healing of the fissures.

Before prescribing your GTN, your doctor will take your medical history. It is not prescribed to pregnant and breastfeeding women. You should also let your doctor know if you have an underactive thyroid, low blood pressure, heart disease, headaches, brain injury or any other health issues. Apart for this, make sure you tell your doctor if you are taking any supplements, have been applying topical steroids for anal fissures or are allergic to anything.

Read the instructions given in the leaflet before using the medicine. We insist you to wear disposable gloves for applying the medicines for hygiene purpose. The medicine is used every 12 hours a consistent period until your doctor notices improvement in the fissures. Apart from healing the fissures, GTN ointment also manages the pain and burning sensation associated with anal fissures.

One of the most common side effects of GTN is headache. So avoid drinking alcohol while using this medicine. Inform your doctor if you experience any other unusual symptoms.

Botulinum toxin injection

Botox injection (Botulinum toxin type A) is a latest treatment option for chronic anal fissures.  The toxin is injected directly into the internal anal sphincter under general or local anaesthesia to paralyse it temporarily. This is how the spasm and tension from the sphincter muscle is released which promotes healing of the cuts and tears in the anus.

Botox injection is an expensive treatment and before giving the injection your doctor will inform you about the probable side effects. The results are quite promising- about 50-80% of people have gotten rid of the fissures with Botox injections. The only downside is that- symptoms can recur within 3 years of taking the injection. If the fissures didn’t heal then you might need to take another shot after a certain interval.

Common side effects are gas incontinence, faecal incontinence and pain at the injection side.

Calcium channel blockers

You doctor might also prescribe you calcium channel blockers for treating the chronic fissures. This group of drug is used to reduce hypertension and so the same mode of action is observed on anal blood circulation. It reduces tension from the anal sphincter and stabilized blood flow.

Your doctor might prescribe you topical ointment or give you tablets.  We repeat again, read the instructions carefully on the label and follow the dosage as advised by your doctor.

Side effects of calcium channel blockers are headache, dizziness and itching in anus post application.

Surgical treatment

Surgical treatment is one of the most promising and successful treatment choices for chronic anal fissures. The most popular and effective surgery is internal sphincterotomy, which involves removing a portion of the sphincter muscle to reduce the pressure and tension from the anus.

Another method used is- Fissurectomy which involves removing anal fissures surgically. This is not as effective as sphincterotomy but may be useful in children with chronic fissures.

Written by: healthplus24.com team

Date last updated: December 17, 2014