Anal Fissures

An anal fissure is a small tear in the skin around the back passage. This can happen as a result of constipation. The underlying cause of anal fissure is thought to be too high a pressure in the anal canal.

Pain during defecation and passing bright red blood on toilet paper after a bowel movement are highly suggestive of an anal fissure.

First line treatment for anal fissures is usually with a topical cream called Anoheal ( 2% Diltiazem) which causes the muscles around the back passage to relax and increases blood supply to that area allowing the anal fissure to heal in 60% of cases. This cream is expensive (€150 per tube and must be kept refrigerated, and so should be used sparingly)

The next line of treatment if Anoheal is not successful is Injection of Botulinum Toxin (Botox) This involves the injection of Botox into the internal anal sphincter muscle. The Botox causes weakening of the muscle for 3-4 months which allows the fissure to heal. This is done under General Anaesthetic, as a day case.

Post Op

Continue to take pain relief if required however hopefully due to the procedure you will find that these will not be required.

It is important not to get constipated therefore you may be advised to take laxatives following the procedure in order to prevent this.

Ensure you eat a healthy balanced diet including plenty of fresh fruit and vegetables. Ensure you drink plenty of fluids.