Anal Fissure Treatment | Symptoms, Causes and Treatment Options: Joshua Franklyn MS FRCS

Anal Fissures Treatment

Treatment is tailored depending on whether the fissure is acute (recent) or chronic (long-standing).

Non-Surgical (Conservative) Treatment

High-fiber diet (fruits, vegetables, whole grains)

Adequate hydration

Stool softeners

Warm sitz baths (10–15 minutes, 2–3 times daily)

Topical medications to relax the anal sphincter

Topical ointments to break the pain and spasm cycle

These treatments aim to:

Reduce pain
Improve blood flow
Promote natural healing

Understanding Anal Fissures

What is an Anal Fissure?

An anal fissure is a small tear in the lining of the anal canal, most commonly caused by passing hard stools or straining during bowel movements. It is a common and treatable condition, but can cause significant discomfort if not addressed early.

Symptoms of Anal Fissure

Patients with an anal fissure may experience:

Severe pain during and after passing stools
Bright red bleeding on toilet paper
Burning or tearing sensation
Fear of bowel movements due to pain
Occasional itching or irritation

Surgical Treatment (Definitive Treatment)

For chronic fissures and fissures not responding to conservative management:

Examination under anaesthesia and Botox Injection to help relax sphincter muscles
Lateral anal sphincterotomy usually reserved for patients with refractory situations

When Should You See an Anal Fissure Specialist? You should consult an Anal Fissures surgeon if:

Pain is severe or persistent
Bleeding continues
Symptoms do not improve within 2–3 weeks
There is uncertainty about the diagnosis

Early evaluation ensures accurate diagnosis and effective treatment, while also ruling out other conditions.

FAQs - Anal Fissures

Can an anal fissure heal without surgery?

Yes, most acute fissures heal with conservative treatment such as diet changes, hydration, and medications. Surgery is reserved for chronic or persistent fissures.

Can anal fissure mimic haemorrhoids?

Yes, there is significant symptom overlap and it is important to have a reasonably accurate diagnosis to ensure targeted treatment is offered. A specialist colorectal surgeon should be able to make a diagnosis and initiate treatment. Occasionally sigmoidoscopy may be performed to rule out other lower GI causes of anorectal bleeding and pain.

How long does it take for an anal fissure to heal?

Acute fissures may heal within a few weeks, while chronic fissures may take longer and sometimes require surgical treatment.

Is anal fissure surgery painful?

This depends on the procedure. Botox injection is pain free, however lateral sphincterotomy is more painful. However, the procedure is generally well tolerated. Most patients experience significant relief from fissure pain after surgery.

Can anal fissures come back after treatment?

Recurrence is possible but can be minimised by maintaining a high-fiber diet, staying hydrated, and avoiding constipation and straining.

Anal Fissures Treatment & Surgery Locations

Anal Fissures Treatment in Oxford and Banbury

Patients seeking anal fissures treatment in Oxford and Banbury can consult Mr Joshua Franklyn, Consultant Robotic General and Colorectal Surgeon, who practises at hospitals in the Oxford and Banbury area. Anal fissures can cause significant pain, discomfort and bleeding, particularly during or after passing a bowel movement.

A clinical assessment can help confirm the diagnosis and determine the most appropriate treatment. Depending on the severity and duration of symptoms, treatment may initially involve non-surgical measures. For patients who do not improve with conservative treatment, anal fissures surgery in Oxford and Banbury may be considered where appropriate.

Anal Fissures Treatment in Harpenden and St Albans

Patients seeking anal fissures treatment in Harpenden and St Albans can consult Mr Joshua Franklyn, Consultant Robotic General and Colorectal Surgeon, who practises at hospitals in the Harpenden and St Albans area. Anal fissures can cause considerable pain, particularly when passing a bowel movement, as well as discomfort and rectal bleeding.

A specialist assessment can help establish the cause and severity of symptoms and identify the most appropriate treatment. Depending on the individual circumstances, treatment may initially involve non-surgical measures. For patients with persistent or troublesome symptoms, anal fissures surgery in Harpenden and St Albans may be considered where clinically appropriate.