The treatment approach for an anal fissure can vary depending on the phase it is in. Most acute fissures can be healed with the ointments prescribed by a doctor. However, chronic fissures often require surgical intervention. We will discuss medication-based, surgical, and non-surgical methods that can be preferred in the treatment of anal fissures.
Surgical Treatment for Anal Fissure
Surgical procedures are divided into surgical and non-surgical methods. One of them is the surgical procedure called Lateral Internal Sphincterotomy (LIS), and the other is Botulinum toxin injection.
Botulinum Toxin Injection
This is a treatment that can be done in 1 minute without requiring any anesthesia or rest. It offers several advantages for the patient. In this method, about 0.5 ml of the medication is injected into the right and left anal muscles. Although there may be a slight discomfort during the application, it is not unbearable. This method, which does not require any incisions, stitches, dressings, or rest, can be used in the treatment of most anal fissures.
What are the Advantages?
- No unpleasant occurrences such as fecal or gas incontinence.
- No fear of surgery.
- No anesthesia is applied.
- Completed in a short time, approximately 1 minute.
- Minimal level of pain.
- No need for rest. The patient can resume daily activities, work, school, or social life immediately after the treatment.
- The success rate in treatment is around 95%.
- No complications such as inflammation or bleeding occur.
Lateral Internal Sphincterotomy (LIS) Surgery for Treatment
LIS stands for Lateral Internal Sphincterotomy, meaning cutting the inner sphincter muscle from the side of the anus. As the name implies, the tight muscle is cut from the side of the anus to provide relaxation. Once relaxation is achieved, the symptoms will subside, and the fissure wound will begin to heal. It can be considered the only current surgical method used in the treatment of anal fissures. Previous surgical methods, despite being used in the past, have been abandoned due to the negative effects they caused. LIS surgery may rarely result in side effects such as gas and fecal incontinence.
Medication-Based Treatment for Anal Fissure
In the acute or initial stage of fissures, rectogesic, rectoderm, or anuflex ointments with herbal content can be used for healing. Anuflex, with its herbal content and economic advantage, stands out in medication-based treatment. However, as mentioned earlier, there is no rule that every fissure will heal with ointments. It can vary depending on the structure and condition of the anal fissure.
Rectogesic and Rectoderm
Both contain ointments with 0.4% nitroglycerin content. Nitroglycerin may cause side effects such as headaches, dizziness, and nausea. Individuals with acute anal fissure discomfort, when using these ointments, should consider these side effects and use the correct amount. Thanks to the ingredients they contain, these ointments help relax the muscles that cause the formation of the fissure. This, in turn, contributes to the healing of the fissure problem.
Anuflex Ointment
Anuflex ointment is a product that achieves the effects of products containing nitroglycerin and chemical substances mentioned above through herbal means. As it has herbal ingredients, it does not cause any side effects. Through its active ingredients, it relaxes the contracted anal muscles, contributing to the healing of the fissure discomfort. Additionally, Anuflex ointment is economical, considering its price.
In cases where these ointments do not lead to recovery, surgical interventions can be considered for the treatment of anal fissures.
Which Doctor/Department to Consult for Anal Fissure?
For the examination and treatment of anal fissure disease, it is necessary to consult general surgery specialists experienced in proctology who apply current treatment methods. Myself and all proctology specialists at the BEN and IDEA Clinic apply advanced and up-to-date methods for the treatment of anal fissures.
