Medical Treatment for Anal Fissures

Medically reviewed by: Gary H. Hoffman, MD

There Is A First Time For Everything.

An anal fissure is one of life’s more painful conditions.  Often, excruciatingly painful.  And, for patients experiencing the fissure for the first time (yes, it can recur over and over again), the pain is made worse by lack of knowledge as to how to treat the fissure, and by not knowing where to turn for help. Suddenly, proctologist jokes and songs are not humorous anymore.

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Who Can Help?

A proctologist, also known as a colon and rectal surgeon, or coloproctologist, is a general surgeon who has received extra training in caring for diseases of the colon, rectum and anus.  In Los Angeles, West Hollywood and Beverly Hills, the proctologists of Los Angeles Colon and Rectal Surgical Associates are able to offer a comprehensive set of medical therapies to heal your anal fissure, or any of your colorectal needs.

What Is An Anal Fissure?

An anal fissure is a small cut or tear at the anal opening.  As the anus is extremely well endowed with nerve endings, a fissure can be PAINFUL!!!  It can also bleed.  The fear caused by the bleeding, combined with the intense anal pain, often seems to increase the pain to a higher level.  Because of the pain, the underlying anal sphincter muscle goes into spasm, further intensifying the pain.  Compounding this, in those patients who clean the anal area with soap in the mistaken belief that this is a necessary part of anal health, the pain is further heightened.

Tips And Tricks

Your proctologist will gently examine you and may begin giving you the following:

  • Advice on softening your stool.
  • A stern (or not so stern) lecture on the discontinuation of anal soap use.
  • A prescription for a topical anti-inflammatory ointment.  Or,
  • A prescription for a topical anal muscle relaxant which, when placed on the anal area, will allow the muscle to relax,  This aids in the healing process.  Diltiazim® or nitroglycerin are commonly prescribed (use them carefully and apply with a gloved finger as they can cause headaches and dizziness).
  • A possible trial of anal Botox, to temporarily relax the sphincter and allow for healing.
  • Reassurance that time may heal the fissure, and counseling for you to remain patient.

In the majority of patients, all, or some of the above maneuvers will heal the problem.  It must be understood that the likelihood of a recurrence is high, and some of these measures may need to be used over a long period of time.

Los Angeles Colon and Rectal Surgical Associates

Sometimes, despite our best efforts, the fissure will not heal.  A surgical option may be offered.  Your proctologist will answer all of your questions and try to allay your fears.  The operation, known as a lateral internal sphincterotomy, heals the fissure in up to 92% of cases.  The operation is usually offered when permanent relief is not achieved.

At Los Angeles Colon and Rectal Surgical Associates, the physicians are well versed in all aspects of anorectal care and are available at (310)273-2310.  An appointment is all that you need to help you toward the path of recovery.

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