Documented to be the best non-surgical option for prevention and healing of anal fissures. The pranicura treatment is a breakthrough in bringing relief and. However, you should see your gp if you have an anal fissure as they can give you advice and medications to help ease your symptoms and allow the fissure to heal more quickly. Most anal fissures will heal with treatment, although they can happen again easily, particularly if you dont follow the self-help advice outlined below. Topical diltiazem cream versus botulinum toxin a for the treatment of chronic anal fissure a double-blind randomized clinical trial. Lateral sphincterotomy for chronic anal fissure prospective, randomized trial. The goal of anal fissure treatment is to lower the pressure on the anal canal by making stools soft,. Chronic anal fissures (present for 6 weeks or longer), and associated pain, may be treated with glyceryl trinitrate rectal ointment 0. 2 unlicensed (available from special-order manufacturers or specialist importing companies). Limited evidence suggests that the strength used does not influence the. botox injections when topical treatments dont work, injecting botulinum toxin type a. Anal fissure, practice parameters for the management of anal fissures (3 rd revision). an anal fissure (see the images below) is a painful linear tear or crack in the distal anal canal, which, in the short term, usually involves only the epithelium and, in the long term, involves the full thickness of the anal mucosa. File36258file36259for patient education resources, see the digestive disorders center, as well as anal absce. It is essential that topical treatment be continued for 6 to 8 weeks to allow the fissure wound to heal. It is common for patients to stop treatment after early improvement of symptoms, but an early relapse often follows. Your doctor will follow up with you approximately every 6 to 8 weeks to examine the area. the topical treatments are used to allow the anal sphincter muscle, which is usually in spasm, to relax, which provides more slack in the skin surrounding the anal fissure. One of the first topical treatments introduced for anal fissures was a nitroglycerine based ointment. Chemical sphincterotomy-first line of treatment for chronic anal fissure. Documented to be the best non-surgical option for prevention and healing of anal fissures. The pranicura treatment is a breakthrough in bringing relief and.