If symptoms are mild, stool softeners are often among the first attempts at treatment recommended. The chronic constipation that can make it difficult for fissures to heal may also be managed by drinking more water and getting regular exercise to increase circulation to help damaged tissues heal. Patients may also notice improvements with daily warm baths that can help relax tissues and structures like the anal sphincter to encourage healing. Topical creams sometimes provide a more direct form of relief. Recurring anal fissures might be treated with injections of Botox (botulinum toxin type A) or certain blood pressure medications to relax the sphincter.
Surgery for Anal Fissures
While rarely necessary, surgery for anal fissures is sometimes recommended if other treatment attempts aren't preventing recurrence or easing discomfort. The most common procedure performed is a lateral internal sphincterotomy. During this surgery, part of the anal sphincter is removed to minimize muscle spasms and provide room for irritated tissues to fully heal. Most patients who reach a point where surgery is needed respond well to to the procedure.
The most effective way to reduce your odds of experiencing anal fissures is to avoid hard bowel movements as much as possible. If you have regular issues with constipation, you may benefit from a healthy diet that includes more fiber and plant-based foods like whole grains and fruits and vegetables. Pelvic floor and Kegel exercises are sometimes helpful.