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This article was published on July 16, 2012, and was last updated on May 1st, 2019 in Hemorrhoid Banding.
Anal fissures are common, and may affect many adults at least at some point in their lives. For most adults, they are the result of a large or very constipated bowel movement, and will clear up within a few days on their own. However, there are some cases where the anal fissures may not heal, and may cause more longstanding problems. In this case, there are different methods of treating anal fissures that can supply relief.
Although most anal fissures are not dangerous, they can be quite painful. They can be responsible for bleeding after a bowel movement, and if the anal fissure is severe, the pain can be quite intense. Deeper anal fissures may take longer to heal, due to the depth of the wound and the irritated tissue surrounding it. The underlying anal sphincter muscles, which are often irritated in this condition, may keep the skin around the area too tight. This prevents the fissure from healing and causes continued pain, particularly after a bowel movement.
When it comes to treating anal fissures, there are two main methods that are usually applied. First, special creams may be prescribed. These may contain nitroglycerine or even calcium channel blockers. These creams work to relax the spastic anal sphincter muscle, which can allow the fissure to heal. These creams also work to treat the symptoms of discomfort and itching that are common with anal fissures.
If the creams do not work, a physician may inject botulinum toxin (Botox) into the anal sphincter muscle. This is the same medication used for cosmetic purposes. The medication causes the spastic sphincter muscle to relax, and this allows the anal fissure time to heal. The recovery time from this procedure is quite quick and it is often quite successful.
The last option for treating anal fissures is surgery. The surgery performed, a “Lateral Internal Sphincterotomy”, divides the spastic sphincter muscle, and this relaxation allows the fissure to heal. The surgical procedure is quite effective, however it is accompanied by a fair amount of pain, and is accompanied by a significant recovery period. Complications are not common, but they do include a small chance of incontinence. For all of these reasons, surgery should be used as a last option to those sufferers that are not helped by more conservative measures.
If you are experiencing chronic anal fissures, this may be a sign that there is a more serious underlying problem. It is a smart idea to get a regular colorectal cancer screening from an accredited facility. Adults over the age of 50, or those that may be predisposed to colon cancer may need screenings on a more frequent basis.