Anal fissure treatment starts with topical medication and escalates only if needed, up to a day-case procedure for fissures that don’t heal on their own. Most fissures respond well once correctly diagnosed by a specialist.
What is an Anal fissure Treatment?
An anal fissure is a split or tear in the skin of the anal canal, often caused by passing a hard or large stool, causing a cycle of pain and muscle spasm that can make it harder to heal without treatment.
Symptoms worth getting checked
Sharp pain during or after a bowel movement
Bright red bleeding
Spasm or a feeling of tightness
A visible tear or small skin tag nearby
Pain that lingers for minutes to hours afterwards
Symptoms lasting more than a few weeks
Your treatment options
Treatment escalates only as needed, most fissures are managed without surgery.
01 — Diet, fibre & topical treatment
Softening stool and reducing straining, combined with simple topical treatments, resolves many fissures without further intervention.
02 — Topical GTN or calcium-channel blocker ointment
A prescription cream that relaxes the anal sphincter to improve blood flow and support healing, the standard next step for fissures that don't settle with simple measures.
03 — Botox injection
A targeted injection to relax the sphincter muscle, giving the fissure a better chance to heal when creams alone haven't worked.
04 — Lateral sphincterotomy
A day-case surgical procedure for chronic fissures that haven't responded to other treatments, a small, precise cut to relax the muscle and allow healing.
Recovery & aftercare
Most treatment is non-surgical and managed through the practice with regular review. Where surgery is needed, it’s day-case with a clear aftercare plan covering pain relief and bowel management to support healing.
Ongoing pain or bleeding shouldn't be assumed to be "just a fissure" without assessment, particularly if it doesn't improve within a few weeks of simple measures.
Recovery, honestly
Simple measures: relief within one to two weeks for many people.
Ointment or Botox: a bit more patience needed, improvement over several weeks rather than days.
Sphincterotomy: quick recovery for most, back to normal activity within days, with the fissure itself fully healed over the following weeks.
