Anal Fissure Medical Treatment

Non-Surgical Methods in the Treatment of Anal Fissure Disease

In the treatment of acute fissure, the patient should consult his physician as soon as possible after his current complaints and keep in mind that anal fissures can be improved with non-surgical suggestions and lifestyle adjustments. Unfortunately, patients attribute most of their existing complaints in these disease groups, where the sense of privacy predominates, to hemorrhoidal diseases. They are stuck in the density of information in their immediate environment and on the internet, causing delays in the disease with the so-called "treatment methods" they provide with their own means, and the current situation causes anal fissures to deepen. It can become chronic and even progress to an infected focus, resulting in anal abscess and anal fistula.

Classified as acute anal fissures; It is a classical knowledge that conservative treatment methods for anal fissures, which are superficial and the patient's entire history does not exceed 6 weeks, include fiber diet, hot water baths with a shower head and, when necessary, application of local anesthetic pomades to the anal area, providing a large and rapid recovery. According to literature information, up to 90% improvement has been found in the treatment of acute anal fissure with just adding bran to the diet and hot water baths twice a day. In chronic anal fissures, success rates fall below 30% with the conservative approaches listed above. Therefore, it has been accepted that more radical treatments should be applied to reduce internal muscle spasm (Internal Anal Sphincter muscle tone) in a case that has had symptoms for weeks and has been diagnosed with chronic anal fissure by an experienced proctologist.

In modern surgical practice, the treatment algorithm of chronic anal fissures has been determined based on scientific evidence with support from the literature. As will be discussed in detail in our other topics, three main treatment methods for chronic anal fissure have been determined, beyond conservative approaches: non-surgical GTN-containing ointments, botox injection application and surgical Lateral internal sphincterectomy surgery. The main target of all these treatment methods is the internal muscle groups, with the aim of normalizing the increased resting pressures in chronic anal fissure patients.