ANAL FISSURES It is a painful tear at the lower end of the anal canal. Anal fissure typically occur after the passage of a hard constipated motion. It sometimes is associated with other pathological processes in the colon. Like other small tears in the body an anal fissure may heal by itself within 14 – 21 days. During this period a patient should: Increase the fibre in their diet Increase the oral fluid intake Not delay a bowel movement when urge to defecates occurs Apply topical ointments including a local anesthetic ointment and / or glycerol trinitrate preparation Sit in a warm sitz bath 2 – 3 times/day Oral analgesia may be required If inspite of the above no improvement has been achieved, then other interventions may have to be considered. This includes amongst others: Internal Sphincterotomy Botulinum toxin injection Both the above can be done as a day procedure operation with excellent long term results. Recovery following surgery ...