Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences:
- Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually.
- Drink adequate fluids. Fluids help prevent constipation.
- Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure.
- Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear.
If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your infant's doctor.
Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing.
- If your symptoms persist, you'll likely need further treatment.
Nonsurgical treatmentsYour doctor may recommend:
- Externally applied nitrogylcerin, to help increase blood flow to the fissure and promote healing, and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache.
- Steroid creams, to help relieve discomfort.
- Botulin toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
- Blood pressure medications, which can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin in not effective or causes significant side effects.
SurgeryIf you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Surgery usually involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and promote healing. Surgery has a small risk of causing incontinence.