Anal Fissure

Home Treatment

Most short-term (acute) and a few long-term (chronic) anal fissures will heal with home treatment.

• Increasing the amount of fiber in your diet heals a fissure by preventing constipation. Stools that are soft and easy to pass gently stretch the anus and will not reopen a healing fissure. Eat fruits, vegetables, and whole grains. Fiber supplements such as Citrucel and Metamucil also can add bulk to your diet.
• When you increase fiber in your diet, drink plenty of water or other fluids.
• Stool softeners or laxatives can make bowel movements more comfortable. Ask your doctor how long you should take laxatives.
• Sitting in a tub filled with a few inches of warm water (sitz bath) for 20 minutes 2 or 3 times a day soothes the torn tissue and helps relax the internal anal sphincter. This may help heal the anal fissure.
• You may want to use ointments or creams such as zinc oxide, Preparation H, or Anusol (which includes an anesthetic). But evidence suggests that fiber and sitz baths help symptoms better than nonprescription creams.¹ Creams with hydrocortisone (such as Anusol-HC) can reduce itching and inflammation.
• Although some people may be tempted to use a mirror or have a family member examine a fissure, do not separate the buttocks. Doing so might slow healing of the fissure.
• Instead of using toilet paper, use baby wipes or medicated pads, such as Tucks, to clean after a bowel movement. These products can be less irritating to an anal fissure.

Conservative treatment measures—including using stool softeners or bulking agents and taking regular sitz baths—allow about 9 out of 10 acute anal fissures to heal. And about 4 out of 10 long-term (or chronic) anal fissures will heal after conservative treatment is used.¹

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Author:	Monica Rhodes	Last Updated: May 30, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine C. Dale Mercer, MD, FRCSC, FACS - General Surgery
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