Anal fissure is a small tear in the lining of the anus that can cause sharp pain, bleeding, and discomfort during bowel movements. While fissures can sometimes heal with medicines and dietary changes, many patients continue to suffer from recurring or chronic fissures.
Doctors often prescribe medicines and ointments to ease symptoms and promote healing. But are these medicines enough, or is surgery the only permanent solution? Let’s find out.
Table of Contents
Commonly Prescribed Medicines for Anal Fissure
1. Painkillers
Purpose: To relieve severe pain and burning during bowel movements.
Examples: Paracetamol, Ibuprofen, Diclofenac.
How They Work: They reduce inflammation and provide temporary pain relief.
Limitation: Do not heal the fissure; pain usually returns once medicine wears off.
2. Laxatives and Stool Softeners
Purpose: To prevent constipation and reduce straining.
Examples: Lactulose, Isabgol (psyllium husk), Polyethylene glycol.
How They Work: They soften the stool, making it easier to pass without tearing the anus further.
Limitation: Only helpful in symptom management; fissure can still persist.
3. Topical Ointments
Purpose: To relax anal muscles and improve blood flow for faster healing.
Examples:
Nitroglycerin ointment – Relaxes anal sphincter muscles.
Diltiazem cream – Reduces anal sphincter spasm.
Lidocaine gel – Provides temporary pain relief by numbing the area.
How They Work: By reducing muscle tightness, blood supply increases, promoting healing.
Limitation: May heal acute fissures, but chronic fissures often return once treatment stops.
4. Antibiotics (in specific cases)
Purpose: To prevent or treat infection if fissure gets infected.
Examples: Metronidazole (oral or topical).
How They Work: Control bacterial growth and reduce the risk of abscess.
Limitation: Only supportive, do not heal fissure.
Do Medicines Permanently Cure Anal Fissure?
The answer is No.
Medicines may help control pain, reduce constipation, and heal minor fissures. However, in chronic or recurrent fissures, the tear does not heal permanently with medicines. The problem often returns once medications are stopped.
This is because anal fissures are often linked to increased sphincter muscle tightness, which medicines cannot fully correct in the long run.
Why Surgery is the Permanent Solution for Anal Fissure
For patients with chronic fissures, repeated recurrences, or severe pain, surgery is considered the most effective and permanent treatment option.
Surgical Options:
Lateral Internal Sphincterotomy (LIS) – The most commonly performed surgery; it reduces anal sphincter pressure and promotes healing.
Laser Fissure Surgery – A minimally invasive procedure with faster recovery and less pain.
Benefits of Surgery:
Provides permanent relief from pain and bleeding
Quick recovery (most patients resume normal life in a few days)
Daycare procedure with no major hospital stay
Low recurrence rate compared to medicines
When to Consider Surgery?
You should consult a surgeon if you:
Have persistent anal pain or bleeding despite medicines
Suffer from chronic fissures (lasting > 6 weeks)
Experience repeated recurrence even after topical ointments/laxatives
Cannot carry out daily life activities due to fissure pain
Final Takeaway
Medicines like painkillers, laxatives, and ointments play a vital role in short-term fissure relief and may heal acute fissures. But for chronic or severe cases, they only provide temporary management.
Surgery remains the only permanent and long-term solution for anal fissure.
If you are struggling with recurrent fissures, consult an experienced surgeon to explore advanced surgical options for lasting relief.
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