citation needed] Non-surgical treatments are recommended initially for acute and chronic anal fissures. (wikipedia.org)
To compare surgical and chemical sphincterotomy for treatment of chronic anal fissure. (scielo.org.za)
Nonsurgical treatment of chronic anal fissure: nitroglycerin and dilatation versus nifedipine and botulinum toxin. (scielo.org.za)
3. Dorfman G, Levitt M, Platell C. Treatment of chronic anal fissure with topical glyceryl trinitrate. (scielo.org.za)
5. Madalinski M, Kalinowski L. Novel options for the pharmacological treatment of chronic anal fissure - role of botulin toxin. (scielo.org.za)
Randomized clinical trial comparing oral nifedipine with lateral anal sphincterotomy and tailored sphincterotomy in the treatment of chronic anal fissure. (scielo.org.za)
11. DasGupta I, Franklin J, Dawson PM. Successful treatment of chronic anal fissure with diltiazem gel. (scielo.org.za)
Topical glyceryl trinitrate in the treatment of chronic anal fissure. (scielo.org.za)
13. Fruehauf H, Fried M, Wegmueller B, Bauerfeind P, Thumshirn M. Efficacy and safety of botulinum toxin injection compared with topical nitroglycerin ointment for the treatment of chronic anal fissure: a prospective randomized study. (scielo.org.za)
14. Minguez M, Herreros B, Espi A. Long-term follow-up (42 months) of chronic anal fissure after healing with botulinum toxin. (scielo.org.za)
15. Arroyo A, Pérez F, SerranoP, Candela F, Lacueva J, Calpena R. Surgical versus chemical (botulinum toxin) sphincterotomy for chronic anal fissure: long-term results of a prospective randomized clinical and manometric study. (scielo.org.za)
A combined surgical and pharmacological treatment, administered by colorectal surgeons, is the direct injection of botulinum toxin (Botox) into the anal sphincter to relax it. (wikipedia.org)
The 160 patients studied were randomly divided into four equal groups, treated by lateral internal sphincterotomy (group S), local diltiazem ointment (group D), local glyceryl trinitrate ointment (group GTN), or injection of botulinum toxin into the internal anal sphincter (group BT). (scielo.org.za)
Fissures13
Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. (wikipedia.org)
Anal fissures usually extend from the anal opening and are usually located posteriorly in the midline, probably because of the relatively unsupported nature and poor perfusion of the anal wall in that location. (wikipedia.org)
Most anal fissures are caused by stretching of the anal mucous membrane beyond its capability. (wikipedia.org)
However, some anal fissures become chronic and deep and will not heal. (wikipedia.org)
In older adults, anal fissures may be caused by decreased blood flow to the area. (wikipedia.org)
Other common causes of anal fissures include: childbirth trauma in women anal sex Crohn's disease ulcerative colitis poor toileting in young children. (wikipedia.org)
External anal fissures on the anal verge can be diagnosed by visual inspection. (wikipedia.org)
citation needed] Internal anal fissures in adults on anterior side, posterior side or within any part of the inner circumference of the anal sphincter muscle can be diagnosed with beak proctoscope 23mm diameter, Chelsea Eaton anal speculum 23mm diameter, Park anal retractor or by digital rectal examination with a finger inside the anal sphincter muscle. (wikipedia.org)
Narrow anal fissures might not be felt by finger during rectal examination due to the glove. (wikipedia.org)
citation needed] Note that colonoscopy, sigmoidoscopy, or normal proctoscopy is for diagnosing internal hemorrhoids and other internal rectal diseases and not for diagnosing anal fissures. (wikipedia.org)
For adults, the following may help prevent anal fissures: Avoiding straining when defecating. (wikipedia.org)
Use of glyceryl trinitrate ointment in the treatment of anal fissures. (scielo.org.za)
Nifedipine2
Local application of medication to relax the sphincter muscle, thus allowing the healing to proceed, was first proposed in 1994 with nitroglycerine ointment, and then calcium channel blockers in 1999 with nifedipine ointment, and the following year with topical diltiazem. (wikipedia.org)
Branded preparations are now available of topical nitroglycerine ointment (Rectogesic (Rectiv) as 0.2% in Australia and 0.4% in UK and US), topical nifedipine 0.3% with lidocaine 1.5% ointment (Antrolin in Italy since April 2004) and diltiazem 2% (Anoheal in UK, although still in Phase III development). (wikipedia.org)
Ointment1
In cases of pre-existing or suspected fissure, use of a lubricating ointment (It is important to note that hemorrhoid ointment is contraindicated because it constricts small blood vessels, thus causes a decrease in blood flow, which prevents healing). (wikipedia.org)
Results2
The most common cause of non-healing is spasming of the internal anal sphincter muscle which results in impaired blood supply to the anal mucosa. (wikipedia.org)
Long term results of open and closed sphincterotomy for anal fissure. (scielo.org.za)
Treatment3
Similarly, prompt treatment of diarrhea may reduce anal strain. (wikipedia.org)