This is a tear or ulcer that develop in the lining of the anus. It causes sharp pain with passing motions, often followed by deep burning pain that may lest several hours. A small amount of red blood in the stool or on the toilet paper can be noticed. Initial measures of treatment include increasing your daily intake of daily fibres and oral fluid intake, laxatives, pain killers, ointments relaxing the sphincter muscle and increasing the blood supply to the fissure to help healing such as Glycryl trinitrate and Calcium channel blockers (Deltiazem). If this fail, injection of botulinum toxins in the anal region can be considered. This should prevent the muscle from spasming, helping to reduce pain and allowing the fissure to heal. There are other surgical options that can be considered if other treatments have not worked.
– Lateral sphincterotomy: involves making a small cut in the ring of muscle surrounding the sphincter to help reduce the tension in your anal canal. This allows the anal fissure to heal and reduces your chance of developing any more fissures.
– Advancement anal flaps: involve taking healthy tissue of the lining of the anus and lower rectum and using it to repair the fissure and improving the blood supply to the site of the fissure.