What Are the Treatments for Anal Fissures?

Causes and Symptoms

• Small tears can develop in the anus after straining during bowel movements or passing hard or large stools. Fissures also can form as a result of inflammatory bowel disease, childbirth, effects of aging or anal sex. Anal fissures often cause bleeding, pain or itching in the anus. Moving your bowels can cause intense pain, burning and bleeding. You first may become aware of a fissure after finding blood on a piece of toilet paper after a bowel movement.
  
  

Treating Infants

• Changing your baby's diaper on a regular schedule and making sure that the anal area is kept clean can help your child's fissure heal. Your doctor may recommend making changes to your baby's diet to avoid constipation in the future.
  
  

Keeping Clean

• Adults also can benefit by keeping the anal area clean. Cleaning promotes healing and should be performed after every bowel movement. Baby wipes or cotton pads saturated with witch hazel can be used to clean the anal area.
  
  

Medication

• Several medications used to treat hemorrhoids also may be helpful in treating anal fissures. Over-the-counter ointments and creams, such as Preparation H or Cortaid, contain hydrocortisone, which works by reducing inflammation around the anus. Prescription-strength hydrocortisone medication also can be used to relieve itching and reduce inflammation and redness. Nitroglycerine ointment can help reduce spasms in the anus and open up blood vessels.
  
  

Botox

• If spasms are causing pain or increasing the size of anal fissures, treatment with the botulinum toxin (Botox) may be recommended. Botox is injected into the internal anal sphincter, causing paralysis of the sphincter for up to three months. According to Hemorrhoid.net, healing of fissures occurs in 60 percent of people injected with Botox. Side effects of Botox treatment include leakage of stool and an increase in the passage of gas.
  
  

Surgery

• Surgery usually only is indicated if healing doesn't occur with more conservative treatment. During surgery, part of the anal sphincter muscle is cut to encourage healing and reduce spasm. The fissure and any scar tissue present also may be removed, along with any hemorrhoids that may have formed. In rare cases, cutting the sphincter muscle may cause a loss of the ability to control bowel movements.
  
  

Prevention

• You can reduce your chances of developing an anal fissure by using soft toilet paper and cleaning the anus with moistened wipes or cotton pads. Avoid straining during bowel movements, because pressure can cause the formation of new fissures. Eating a diet high in fiber produces soft stools, which pass through the rectum and anus more readily. If a change in diet is not having the desired effect, taking fiber supplements may help. Staying active also is important in avoiding fissures; exercise helps promote regular bowel movements and decreases the likelihood of constipation.