Treatment for anal fissures can include self-care, medications or surgery.
As a first step, doctors generally recommend self-care measures to soften stools:
- Consuming additional liquids and fiber
- Taking stool bulking agents such as psyllium products
Anal fissures that don't respond to self-care or that have other underlying causes will be treated either by medication or surgery.
- Nitroglycerin or nifedipine paste might be prescribed to apply around the anus a few times a day to relax the muscle and increase blood flow to promote healing.
- Botox (onabotulinumtoxinA) injections may be prescribed to relax the anus.
- Lateral internal sphincterotomy. In this common surgery, a small portion of the inner part of the sphincter muscle is cut, relaxing the anus and allowing the fissures to heal. This outpatient surgery has a small risk of gas or stool incontinence or fissure recurrence.
Read more about treatment of anal fissures on MayoClinic.com.