digestive disorders
Anal Fissure
Treatment of Anal Fissure
Stool softeners and fiber Protective ointments and sitz baths Botulinum toxin injection ornitroglycerinointment or calcium channel blockers A stool softener and fiber supplements or increased dietary fiber may reduce the possibility of injury by hard or large bowel movements. Healing is aided by usingzinc oxideointments orglycerinsuppositories that lubricate the lower rectum and soften stool. Applying topical anesthetics (such asbenzocaineorlidocaine) to the anus or soaking in a warm (not hot) sitz bath for 10 to 15 minutes after each bowel movement eases discomfort and helps increase blood flow, which promotes healing. The soaking is accomplished by squatting or sitting in a partially filled tub or using a container filled with warm water placed on the toilet bowl or commode. To reduce anal sphincter spasms and promote healing of fissures, doctors may inject the anal sphincter with botulinum toxin or have the person applynitroglycerinointment or calcium channel blockers (such asnifedipinecream ordiltiazemgel) to the area of the fissure. If these measures do not work, surgery may be needed. To relieve sphincter spasms, doctors cut a portion of the internal sphincter (called internal anal sphincterotomy). 