If you’re suffering from the sharp, burning pain of an anal fissure, you know how uncomfortable and disruptive it can be. The good news? You have multiple quick relief options, and many of them can help you heal fast, without surgery. This guide covers everything you need to know about the best treatment for fissure and when it’s time to consider more advanced options like surgery.
We’ll explore 7 scientifically backed treatments, from simple home remedies to cutting-edge surgical procedures. Whether your fissure is acute (new) or chronic (lasting more than 6 weeks), this guide will help you find the best treatment for anal fissure that suits your needs.
What is an Anal Fissure and its Causes?
An anal fissure is a tear in the skin near the anus, often caused by various factors. The most common cause of anal fissures is constipation, which can lead to increased strain during bowel movements and subsequent tearing of the anal skin.
Other causes of anal fissures include:
- Trauma: Injury or trauma to the anal area, such as from forceful insertion or vigorous wiping, can cause fissures to develop.
- Prior Anal Surgery: Previous surgeries involving the anal area can leave the skin weakened and prone to fissures.
- Chronic Loose Motions: Frequent episodes of diarrhea or loose stools can irritate and weaken the anal area, making it more susceptible to tearing.
- Childbirth and Pregnancy: The process of childbirth or the pressure exerted on the anus during pregnancy can contribute to the development of anal fissures.
- Inflammatory Bowel Diseases: Conditions like Crohn’s disease and ulcerative colitis can cause inflammation and damage to the anal area, increasing the likelihood of fissures.
- Tight Anal Sphincter Muscles: High resting anal sphincter tone, a condition where the muscles around the anus remain tight, can cause excessive pressure on the anal skin and lead to fissures.
- Sexually Transmitted Infections: Certain sexually transmitted infections, such as herpes or gonorrhea, can cause anal fissures as a result of inflammation and tissue damage.
Prompt diagnosis and treatment are crucial to prevent complications and manage the symptoms effectively. If you suspect you have an anal fissure or experience associated symptoms, it is important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.
7 Best Treatments for Anal Fissure: Quick Relief Options That Actually Work
1. Dietary & Lifestyle Changes (First-Line Treatment)
Constipation is the number one trigger for fissures. By softening your stool and improving your bowel habits, you reduce pressure on the anal lining—giving the fissure time to heal.
What You Should Do:
- Increase Fiber Intake: Eat 25–35g daily from fruits, vegetables, nuts, and whole grains.
- Stay Hydrated: Drink at least 8–10 glasses of water per day.
- Avoid Straining: Don’t sit on the toilet too long.
- Warm Sitz Baths: Sit in warm water for 10–20 minutes after bowel movements to relax your anal muscles.
| Home Remedies for Anal Fissures | Benefits |
|---|---|
| Regular exercise | Manage constipation and promote healthy bowel movements |
| Hydration | Prevent dehydration and soften stools |
| Fiber-rich diet | Softens stools and prevents constipation |
| Sitz baths | Relieve pain and inflammation in the anal area |
| Petroleum jelly | Soothes the skin and reduces friction during bowel movements |
Best for: Early-stage or mild fissures
Not enough for: Chronic or severe fissures
2. Topical Medications (Ointments & Creams)
These are usually your next step if lifestyle changes aren’t enough.
A. Nitroglycerin (Glyceryl Trinitrate – GTN) Ointment
- How it works: Increases blood flow to the fissure and relaxes the anal sphincter.
- Application: 2–3 times/day for 6 weeks.
- Side Effects: Headache, dizziness.
Heals up to 70% of chronic fissures if used correctly.
B. Lidocaine Gel or Cream
- Purpose: Provides temporary pain relief but doesn’t speed up healing.
- When to use: Before and after passing stool.
C. Calcium Channel Blockers (Diltiazem/Nifedipine)
- How it works: Similar to GTN—relaxes sphincter, boosts healing.
- Application: Applied topically for at least 6 weeks.
- Side Effects: Mild burning, headache.
| Medication Type | Function | Common Brand Name | Duration |
|---|---|---|---|
| Nitroglycerin (GTN) | Heals fissure, relaxes muscle | Rectiv | 6 weeks or more |
| Lidocaine | Pain relief only | Xylocaine | Short-term use |
| Diltiazem/Nifedipine | Heals fissure | Generic | 6–8 weeks |
Best for: Chronic fissures not healing with self-care
Not suitable for: Children or pregnant women (without doctor’s advice)
3. Laxatives (To Soften Stool)
Hard stools keep re-tearing your fissure. Laxatives can break this cycle.
Types:
- Bulk-forming: Psyllium husk, methylcellulose
- Osmotic: Lactulose or polyethylene glycol (especially for kids)
| Laxative Type | How It Works | Example |
|---|---|---|
| Bulk-forming | Adds fiber to retain water in stool | Isabgol |
| Osmotic | Draws water into colon, softens stool | Lactulose |
Best for: Constipation-linked fissures
Overuse can cause dependency, use under medical advice
4. Botulinum Toxin (Botox) Injection
If ointments don’t work, Botox may be the best treatment for anal fissure before surgery.
How It Works:
- Botox paralyzes the anal sphincter temporarily, preventing spasms that stop healing.
- Effect lasts 2–3 months, often enough for healing.
Procedure:
- Performed in a clinic or hospital
- Local anesthesia or mild sedation used
- No downtime
Healing rate: Over 50% success in chronic fissures
Temporary results; might need repeat shots
5. Lateral Internal Sphincterotomy (LIS) – Gold Standard Surgery
If your fissure hasn’t healed in 6–8 weeks despite treatment, LIS is the most effective and permanent solution.
What It Is:
LIS involves cutting a small part of the internal anal sphincter muscle to reduce pressure and allow healing.
How It’s Done:
- Done under general anesthesia
- Daycare surgery, no overnight hospital stay
- Recovery in 2–4 weeks
| Feature | Details |
|---|---|
| Success Rate | Over 90% |
| Healing Time | 2–4 weeks |
| Incontinence Risk | <5%, usually temporary |
Best for: Chronic fissures not healing with medicine
Rare risk: Mild gas or stool leakage (usually resolves)
6. Advancement Flap Surgery
A less common option, usually for complex or pregnancy-related fissures.
Procedure:
- Healthy tissue (often from rectum) is moved over the fissure.
- Helps increase blood flow and promotes healing.
Best for: Fissures due to trauma or childbirth
Requires expert colorectal surgeon
7. When to See a Specialist
You should see a gastroenterologist if:
- Pain persists after 6 weeks
- You notice blood with every stool
- Medications don’t help
- You’ve had multiple fissures
Ignoring chronic fissures can lead to infections or complications like fistulas.
Comparison Table: Medical vs Surgical Treatments
| Treatment Type | Healing Time | Suitable For | Risk of Recurrence | Side Effects |
|---|---|---|---|---|
| Dietary Changes | 2–4 weeks | Mild fissure | Moderate | None |
| Topical GTN | 4–6 weeks | Chronic fissure | Moderate | Headaches, dizziness |
| Calcium Blockers | 6 weeks | Chronic fissure | Moderate | Local irritation |
| Botox Injection | 2–3 months | Non-healing cases | Low | Temporary effect |
| LIS Surgery | 2–4 weeks | Resistant fissures | Very Low | Mild incontinence (rare) |
| Flap Surgery | 4–6 weeks | Complex cases | Low | Surgical risks |
How Long Does it Take for Anal Fissures to Heal?
The healing time for anal fissures can vary depending on various factors, including the severity of the fissure, the chosen treatment, and individual differences. Acute fissures, which are recent tears, may show improvement within a few days to a week when proper treatment is followed, and they can completely heal within a few weeks. On the other hand, chronic fissures, which are older or recurring tears, may take longer to heal, and treatment can last several weeks to a few months.
It is crucial to follow the recommended treatment plan provided by your healthcare provider to facilitate the healing process. A combination of at-home remedies, such as sitz baths and dietary changes, along with medical treatments, like topical ointments or surgical interventions, may be prescribed based on the severity and duration of the fissure.
Consulting with a healthcare professional is essential for proper monitoring and guidance throughout the healing process. They can assess your specific condition, provide personalized advice, and make adjustments to the treatment plan as needed.
Remember, the healing time for anal fissures can vary from person to person. Patience and consistent adherence to the treatment plan are key to achieving successful healing and finding relief from the discomfort caused by anal fissures.
| Factors Affecting Healing Time for Anal Fissures | Healing Time |
|---|---|
| Severity of the fissure | Varies; acute fissures can heal within a few weeks, while chronic fissures may take several weeks to months |
| Effectiveness of the chosen treatment | Depends on the individual response to the treatment; may accelerate or delay the healing process |
| Individual differences | Each person’s healing process may vary due to factors such as overall health, immune response, and adherence to treatment |
Factors Affecting Healing Time for Anal Fissures
- Severity of the fissure
- Effectiveness of the chosen treatment
- Individual differences
When to See a Doctor for an Anal Fissure?
If you suspect you have an anal fissure or experience symptoms associated with it, it is advisable to seek medical attention. There are certain indications that should prompt you to consult a healthcare professional:
- Persistent symptoms that do not improve with home treatments.
- Recurrent anal fissures.
- Severe pain or bleeding.
- Fissure complications.
- Underlying health conditions.
- Lack of improvement with at-home treatments.
A healthcare professional can diagnose the fissure, assess its severity, and recommend appropriate treatments. This may include medications, dietary changes, lifestyle modifications, or surgical procedures. Seeking timely medical advice will help ensure the best outcome for your anal fissure.
Recognizing Symptoms That Require Medical Attention
It is important to be aware of the symptoms that may indicate the need to see a doctor for an anal fissure:
- Intense and prolonged pain that does not improve.
- Excessive bleeding or blood in stools.
- Persistent itching or irritation around the anus.
- Difficulty passing stool or feeling like your bowels are not empty.
- Prolonged healing despite following home remedies.
Consulting a healthcare professional will help accurately diagnose the condition and provide the most suitable treatment options.
Symptoms That Require Medical Attention
| Symptoms | Indications |
|---|---|
| Intense and prolonged pain | A healthcare professional should be consulted if the pain does not improve or worsens despite using at-home treatments. |
| Excessive bleeding or blood in stools | Consult a healthcare professional immediately if you experience significant bleeding or notice blood in your stools. |
| Persistent itching or irritation around the anus | Seek medical advice if itching or irritation in the anal area persists for a prolonged period. |
| Difficulty passing stool or feeling of incomplete evacuation | If you have trouble passing stool or feel like your bowels are not empty, it is recommended to see a doctor. |
| Prolonged healing despite following home remedies | If your anal fissure does not show signs of improvement within a reasonable timeframe, consult a healthcare professional to explore alternative treatment options. |
Preventing Anal Fissures
To prevent anal fissures and reduce the risk of trauma to the anal area, it’s important to maintain good bowel habits and follow a few simple guidelines:
- Consume a high fiber diet: Incorporate plenty of fruits, vegetables, whole grains, and legumes in your meals to promote regular bowel movements and prevent constipation. This helps reduce the strain on the anal area and minimize the chances of developing fissures.
- Stay hydrated: Drink an adequate amount of water throughout the day to keep your stools soft and make bowel movements easier. Dehydration can lead to hard, dry stools that can contribute to anal fissures.
- Practice good bowel habits: Avoid delaying bowel movements as holding in stool for long periods can lead to dry, hard stools that are difficult to pass. Additionally, avoid straining during bowel movements, as this can put pressure on the anal area and increase the risk of fissures.
- Use soft and unscented toilet paper: Choose gentle, unscented toilet paper to minimize irritation and trauma to the anal area. Rough or scented toilet paper can cause further discomfort and potentially worsen anal fissures.
- Practice good anal hygiene: After each bowel movement, gently clean the anal area with warm water or unscented wipes. Avoid using harsh soaps or vigorous wiping, as this can irritate the skin and potentially aggravate fissures.
- Engage in regular physical activity: Regular exercise promotes healthy bowel function and helps prevent constipation. Aim for at least 30 minutes of moderate-intensity exercise, such as walking, jogging, or cycling, on most days of the week. Consult with your healthcare provider before starting any new exercise program.
Which Option is Right for You?
If you’re wondering what the best treatment for fissure is—it depends on your symptoms, how long you’ve had them, and whether you’ve tried home treatments already.
- For mild cases, diet and ointments may be enough.
- For persistent fissures, Botox or LIS surgery offers fast, lasting relief.
- Complex cases like post-pregnancy fissures may need flap surgery.
Book Your Consultation with Dr. Nivedita Pandey Today
Still unsure what step to take next? Don’t suffer in silence.
Dr. Nivedita Pandey, MBBS, Diplomate of the American Board (Internal Medicine & Gastroenterology), is a US-trained, board-certified Senior Gastroenterologist and Hepatologist based in South Delhi.
She offers compassionate, expert care, especially for women seeking a safe and comfortable space to discuss anal fissure treatment. With extensive experience in fissure treatments, fatty liver, NASH, viral hepatitis, cirrhosis, and post-liver transplant care, you’re in trusted hands.
Take the first step toward healing, book your consultation now with Dr. Nivedita Pandey
FAQ
What is the best treatment for anal fissure?
The best treatment for anal fissure depends on the severity and duration of the fissure. In many cases, anal fissures can heal on their own with home remedies and lifestyle changes. However, for fissures that do not resolve with conservative treatments, medical interventions such as topical ointments, painkillers, or surgical procedures may be necessary. It is important to consult with a healthcare provider for a proper diagnosis and personalized treatment plan.
What are the causes of anal fissure?
Anal fissures can be caused by various factors including constipation, trauma, prior anal surgery, chronic loose motions, childbirth and pregnancy, inflammatory bowel diseases, tight anal sphincter muscles, and sexually transmitted infections. These factors can lead to tears in the skin near the anus, resulting in symptoms such as pain, bleeding, and discomfort. Proper diagnosis and identification of the cause are important for effective management and prevention of complications.
What are some home remedies for anal fissures?
Home remedies for anal fissures include exercising regularly to manage constipation, drinking plenty of water to avoid dehydration, increasing daily fiber intake through fruits, vegetables, and whole grains, and taking sitz baths with warm water multiple times a day. Applying petroleum jelly around the anal region can also provide relief. However, it is essential to consult a healthcare provider for a proper diagnosis and treatment plan, as home remedies may not be sufficient for all cases.
What are the medical treatments for anal fissures?
Medical treatments for anal fissures can include the use of laxatives to relieve constipation, painkillers to manage discomfort, and topical ointments containing glyceryl trinitrate or lidocaine for pain relief. In some cases, botulinum toxin injections or surgical procedures such as a lateral sphincterotomy or advancement anal flaps may be recommended. The choice of treatment depends on the severity and duration of the fissure, as well as individual factors. It is important to follow the advice of a healthcare professional for proper treatment.
How long does it take for anal fissures to heal?
The healing time for anal fissures can vary depending on factors such as the severity of the fissure, the effectiveness of the chosen treatment, and individual differences. Acute fissures may show improvement within a few days to a week with proper treatment and completely heal within a few weeks. Chronic fissures, which are older or recurring tears, may take longer to heal and treatment can last several weeks to a few months. It is important to follow the recommended treatment plan and consult with a healthcare provider for proper monitoring and guidance.
When should I see a doctor for an anal fissure?
It is advisable to seek medical attention if you suspect you have an anal fissure or experience symptoms associated with it. This includes persistent symptoms that do not improve with home treatments, recurrent anal fissures, severe pain or bleeding, fissure complications, underlying health conditions, or lack of improvement with at-home treatments. A healthcare professional can diagnose the fissure, assess its severity, and recommend appropriate treatments, which may include medications, dietary changes, lifestyle modifications, or surgical procedures.
How can I prevent anal fissures?
Preventing anal fissures involves maintaining good bowel habits and reducing the risk of trauma to the anal area. This can be achieved through dietary changes, such as consuming a high fiber diet and staying hydrated, practicing good bowel habits by not delaying bowel movements and avoiding straining, using soft and unscented toilet paper, practicing good anal hygiene, and engaging in regular physical activity. It is important to adopt these preventive measures to minimize the chances of developing anal fissures.
What are the at-home treatment options for anal fissures?
For acute anal fissures with mild symptoms, at-home treatments can be effective in providing relief and promoting healing. These include sitz baths, stool softeners or fiber supplements to ease bowel movements, a high fiber diet to prevent constipation, hydration, topical analgesics for temporary pain relief, and maintaining good anal hygiene. These measures can help alleviate symptoms and improve the healing process. However, if symptoms persist or worsen, it is important to seek medical advice for proper evaluation and treatment.
What are the surgical treatment options for anal fissures?
In cases where other treatments have not been effective, surgical treatment may be recommended for anal fissures. The most common surgical procedure is a lateral sphincterotomy, which involves making a small cut in the ring of muscle surrounding the sphincter to reduce tension and promote healing. Other surgical options include advancement anal flaps, which use healthy tissue to repair the fissure, and botulinum toxin injections to relax the sphincter muscle. Surgery is considered to be highly effective, but it is important to discuss the risks and benefits with a healthcare professional.
How can anal fissures be treated for quick relief?
Anal fissures can be a painful and uncomfortable condition, but with proper diagnosis and treatment, relief is possible. Home remedies and medical treatments can help manage symptoms and promote healing. It is important to seek medical advice for an accurate diagnosis and to determine the most suitable treatment option. Preventive measures such as maintaining good bowel habits and practicing good anal hygiene can reduce the risk of developing anal fissures in the future. Remember to follow the guidance of healthcare professionals and prioritize your health and well-being.
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About The Author
This article is medically reviewed by Dr. Nivedita Pandey, Senior Gastroenterologist and Hepatologist, ensuring accurate and reliable health information.
Dr. Nivedita Pandey is a U.S.-trained gastroenterologist specializing in pre and post-liver transplant care, as well as managing chronic gastrointestinal disorders. Known for her compassionate and patient-centered approach, Dr. Pandey is dedicated to delivering the highest quality of care to each patient.
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