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Most cases of anal fissure heal spontaneously within a few weeks, without requiring treatment. However, some individuals may be affected by a chronic anal fissure that continues to plague them for six weeks or more.
Additionally, the newly healed skin is likely to be weaker for some time and the fissure may therefore easily recur, particularly if the cause of the fissure is not adequately treated.
There are several self-care techniques that can help to increase the ease of passing stools. These assist skin healing following the occurrence of an anal fissure. This helps the skin in the area to develop strength and prevent the recurrence of anal fissures.
Self-care tips to improve recovery for individuals with, or recovering from, an anal fissure, include:
Additionally, if there is a known cause of the anal fissure, such as constipation, this should be addressed to prevent recurrence.
The most problematic symptom associated with an anal fissure is pain, particularly when passing stools.
Simple analgesics such as paracetamol or ibuprofen may be helpful in relieving the pain of an anal fissure. Additionally, the pain of passing stools may be greatly alleviated by soaking the region by sitting in a warm sitz bath regularly, like 2-3 times a day, so that the warmth can relax the anal sphincter muscles.
After going to the toilet, it is best to avoid soap on the anal region which could irritate the sore skin. Instead, use warm water and soft gauze to clean the area and follow it up with a sitz bath. Pat it dry with a soft cloth.
In some cases, other medications may be prescribed to relieve symptoms and improve healing. This may include:
While most patients will not require surgery for an anal fissure, it is recommended for chronic cases when other methods have failed to bring about healing.
Surgery is very effective, with more than 90% of patients reporting positive long-term results. However, it is also associated with a small risk of complications such as bowel incontinence.
Several different surgical techniques may be used:
Most patients will require a follow-up appointment several weeks after treatment, depending on the severity of the anal fissure and the technique used.
Future treatment decisions, if needed, are made on a case-by-case basis, according to the symptoms and previous treatments of the patient. Ongoing care is important for severe anal fissures because the likelihood of recurrence is high.