How to treat anal fissures and anal fistulas
Nov 15, 2025
Source: Cainiu Health
Dr. Li Jingxiang
Introduction
Treatment methods for anal fissures and anal fistulas include surgical treatment, conservative drug therapy, sitz baths, dietary adjustments, and bowel management. An individualized approach should be selected based on the severity of the condition, with priority given to standardized treatments to eliminate the lesion and relieve symptoms. If symptoms such as rectal bleeding, perianal swelling and pain, or pus discharge occur, prompt medical evaluation is recommended for accurate diagnosis.
Methods for treating anal fissures and anal fistulas include surgical treatment, conservative drug therapy, sitz baths, dietary adjustments, and bowel management. Individualized approaches should be selected based on the severity of the condition, with priority given to standardized treatments to eliminate lesions and relieve symptoms. If symptoms such as rectal bleeding, perianal swelling and pain, or pus discharge occur, prompt medical evaluation is recommended for accurate diagnosis.
1. Surgical treatment: This is the primary curative approach for anal fistulas, including procedures such as fistulotomy and seton placement. For recurrent or severe anal fissures, fissurectomy may be required. These surgeries aim to remove diseased tissue, drain abscesses, or repair anal canal skin to achieve a complete cure.
2. Conservative drug therapy: Suitable for mild anal fissures or during remission phases of anal fistula, this includes topical application of hemorrhoid ointments or analgesic creams to reduce pain, and oral antibiotics to control infection and alleviate inflammatory responses. However, this approach rarely achieves complete cure for anal fistulas.
3. Sitz bath care: Sitting in warm water or herbal solutions 1–2 times daily, especially after bowel movements, helps cleanse the perianal area, improve local blood circulation, reduce swelling and pain, and promote wound healing. It is an important supportive treatment before and after surgery.
4. Dietary adjustment: Avoid spicy, stimulating, and greasy foods. Increase intake of fiber-rich fruits, vegetables, and whole grains, and drink plenty of water to soften stools, reduce irritation to the anal canal during defecation, and prevent disease progression or recurrence.
5. Bowel management: Establish regular bowel habits, avoid prolonged squatting or sitting on the toilet, limit defecation time to 5–10 minutes, and avoid straining. This reduces pressure on the anal canal and lowers the risk of worsening anal fissures or recurrent anal fistulas.
In daily life, maintain cleanliness and dryness of the perianal area, wear soft and breathable underwear to minimize friction, engage in moderate gentle exercises such as walking to enhance intestinal motility, avoid alcohol and smoking, and maintain regular bowel habits to support recovery.
