What is the best way to treat anal fissure?

Anal fissure causes great pain to many people, so in order to reduce its impact, we should pay attention to effective treatment and coping measures. Anal dilation therapy can be adopted, and of course, persistence in treatment can completely and effectively solve the problem.

1. Anal dilation

Anal dilation is mainly suitable for stage I and II anal fissures.

Use your fingers or an instrument (you can use the trumpet-shaped anoscope commonly used in anorectal surgery) to dilate the anus. This method is easy to operate and has a certain effect in relieving severe anal pain, but it will recur and may be complicated by adverse reactions such as anal hematoma, bleeding, and anal incontinence for a short period of time. The operation should be gentle, avoid being rough, and use more lubricating ointment. In the case that the patient can tolerate it, proceed step by step.

2. Botulinum toxin injection

Applicable to all stages of anal fissure.

When used, botulinum toxin type A is diluted with 0.9% sodium chloride solution and injected into the internal sphincter on both sides of the fissure. Botulinum toxin type A is an extremely strong neurotoxin. After local injection into the internal anal sphincter, it blocks the release of acetylcholine in the presynaptic membrane of the neuromuscular junction, causing chemical denervation and local muscle paralysis, thereby reducing muscle tension, improving local blood supply, and achieving the purpose of healing anal fissures. Botulinum toxin type A is a safe and effective biological agent. After a small amount of local injection, most of it quickly combines with the muscles at that location. A very small amount of toxin is cleared after entering the blood circulation and will not cause systemic poisoning reactions.

3. Surgical treatment

Anal fissure resection and anal canal release are the safest and most reliable surgical methods in clinical practice.

It is suitable for stage II and III anal fissures. The purpose of the operation is to remove the anal fissure and its appendages and to reduce blood pressure in the anal canal.