How is anal fissure treated?

Nov 15, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

In general, treatment methods for anal fissures mainly include conservative management, topical medication, oral drug therapy, surgical treatment, and physical therapy. In addition, patients should develop regular bowel habits during treatment, avoid spicy and irritating foods, and undergo regular follow-up examinations. If abnormalities such as wound infection or increased pain occur, medical attention should be sought promptly to adjust the treatment plan.

Generally, treatment methods for anal fissures include conservative management, local medication, oral drug therapy, surgical intervention, and physical therapy. Specific details are as follows:

1. Conservative Management

Anal fissures are often associated with poor bowel habits and hard stools; therefore, maintaining smooth bowel movements is fundamental. Patients should increase their dietary fiber intake by consuming more vegetables, fruits, and whole grains, while ensuring adequate fluid intake to soften stools and reduce irritation to the fissure site. Avoid prolonged straining during defecation. After bowel movements, warm water sitz baths help clean the affected area, relieve local muscle spasms, and improve blood circulation.

2. Local Medication Therapy

Topical medications act directly on the wound to alleviate pain and promote healing. Under medical guidance, patients may apply nitroglycerin ointment to relax the internal anal sphincter and improve local blood flow. Recombinant human epidermal growth factor gel can also be used to accelerate wound repair. Additionally, compound azulene cream may be applied to protect the mucosa and reduce irritation.

3. Oral Drug Therapy

Oral medications primarily aim to relieve constipation and pain. For significant constipation, lactulose oral solution or polyethylene glycol 4000 powder can be taken to soften stools. In cases of severe pain, ibuprofen sustained-release capsules may be prescribed under a doctor’s supervision to reduce discomfort and create favorable conditions for wound healing.

4. Surgical Treatment

Surgery is required when conservative treatments fail in chronic anal fissures or when complications are present. Common procedures include anal fissurectomy, which involves removing the fissure and surrounding diseased tissue, and lateral internal sphincterotomy, which partially cuts the internal anal sphincter to relieve spasm, improve local blood supply, and promote healing.

5. Physical Therapy

Physical therapies can assist in symptom relief and speed up recovery. Commonly used methods include warm water sitz baths and infrared radiation. Sitz baths help cleanse the wound and relax the sphincter muscles, while infrared irradiation enhances local blood circulation, reduces inflammation, and accelerates tissue repair.

In addition, patients should develop regular bowel habits during treatment, avoid spicy and irritating foods, and attend follow-up appointments regularly. If signs of wound infection or worsening pain occur, prompt medical consultation is necessary to adjust the treatment plan.

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