Anal Fissure Treatment & Surgery

What is Anal Fissure?

Anal fissure is a small tear in the anoderm causing severe pain with defecation. Usually at posterior midline. Caused by hard stools, chronic constipation, or trauma. Common in young adults and postpartum women. Often self-limited but may become chronic.

Symptoms & Diagnosis

Severe pain during and after bowel movements
Visible tear on physical examination
Bright red bleeding
Spasm of internal anal sphincter

Diagnosis: Clinical examination. Anoscopy if diagnosis unclear.

Treatment Options

Conservative Measures (80% success)

High-fiber diet and stool softeners
Warm sitz baths
Topical anesthetics and nitrates
Calcium channel blockers

Surgical Options

Lateral Internal Sphincterotomy: Gold standard for chronic fissure. Divides internal sphincter fibers. Minimal incontinence risk. 95%+ success rate.

Recovery & Outcomes

Surgical recovery: 1-2 weeks. Pain relief immediate. Return to normal activities 2-3 weeks. Recurrence rate <5% with LIS. Most patients achieve complete healing.