How are anal fissures treated?
Thegoal of treatment for anal fissures is to break the cycle of spasm of the anal sphincter and its repeated tearing of the anoderm. General treatment. In acute fissures, medical (nonoperative) therapy is successful in the majority of patients. Of acute fissures, 80-90% will heal with conservative measures as compared with chronic (recurrent) fissures, which show only a 40% rate of healing. Initial treatment involves adding bulk to the stool and softening the stool with psyllium or methylcellulose preparations and a high fiber diet. Additionally, patients are advised to avoid “sharp” foods that may not be well-digested (i.e., nuts, popcorn, tortilla chips), increase their liquid intake, and, at times, take stool softeners (docusate or mineral oil preparations). Sitz baths (essentially soaking in a tub of warm water) are encouraged, particularly after bowel movements, to relax the spasm, to increase the flow of blood to the anus, and to clean the anus without rubbing the irritated anode
