Anal fissure therapy – conservative measures

An anal fissure is a tear in the anal mucosa that is extremely painful. In addition to conservative measures, surgery is sometimes unavoidable.

Conservative measures

Acute anal fissure resolves on its own in rare cases, but usually requires therapy. If doctors treat the tear in time, anal fissure is easily curable. The following options are available for the treatment of anal fissure:

  • Pain-relieving medication in the form of ointments, suppositories or anal tampons. The latter are suppositories with a mullein insert that release the active ingredient exactly at the sore spot.
  • Muscle-relaxing drugs: Doctors often use ointments containing glycerol trinitrate or so-called calcium antagonists. The active ingredients ensure that the sphincter muscle relaxes. The anal fissure heals better because there is less pressure on it.
  • Warm sitz bath: Many people with anal fissure find this pleasant. They relax the sphincter and thus also protect against constipation.
  • Diet: Consume plenty of fiber and drink enough fluids. The stool becomes soft, you do not have to push during defecation and thus prevent further tears.
  • Botox: Botulinum toxin is a neurotoxin that prevents muscle contraction and causes paralysis. Doctors can inject it into the sphincter muscle that is in spasm, relaxing it. Then the anal fissure can heal better. However, there is a risk of temporary fecal incontinence.


Sometimes these non-surgical (conservative) measures are not enough to make the anal fissure heal. Some sufferers also develop changes in the area of the wound, for example skin folds or anal fistulas. Surgery may be necessary for chronic anal fissure.

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University Hospital Zurich
Department of Gastroenterology and Hepatology
Rämistrasse 100
8091 Zurich

Tel. +41 44 255 85 48
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