Common symptoms:
- Sharp, tearing or burning pain during a bowel motion
- Pain that continues for minutes to hours afterwards, often described as passing glass
- Bright red blood on the paper or on the surface of the stool
- Spasm or aching in the anal area
- Anxiety about opening the bowels, which worsens constipation and feeds the cycle
- A lump or skin tag near the anus in longstanding cases
Bleeding should never be dismissed as a fissure without assessment. Haemorrhoids, inflammatory bowel disease and bowel cancer can produce similar symptoms, and a proper examination separates them.
Haemorrhoids, inflammatory bowel disease and bowel cancer can produce similar symptoms, and a proper examination separates them.
About half of acute fissures heal with conservative measures. Your GP will usually start with stool softening: soluble fibre, more water and osmotic laxatives, aiming for a soft stool that passes without straining.
Topical medications relax the sphincter and improve blood supply. Glyceryl trinitrate ointment or diltiazem cream is applied to the anal margin 2-3 times daily for 6-8 weeks, with healing rates of 50-70% in chronic fissures. Headache limits glyceryl trinitrate, so diltiazem is often better tolerated.
Warm baths ease spasm. Local anaesthetic relieves pain but does not heal. Keep using the cream once symptoms settle, because stopping early may cause treatment failure.
If a fissure fails to heal after a proper trial of topical therapy, Dr Mirbagheri will discuss day procedures performed under general anaesthesia.
Botulinum toxin relaxes the internal sphincter for about three months, allowing healing in roughly 60-80% of cases with minimal continence risk. Recurrence can occur, and a second injection is sometimes offered.
Fissurectomy trims the chronic fibrous edges to create a fresh wound, and combining it with botulinum toxin improves results over either alone.
Lateral internal sphincterotomy divides part of the internal sphincter and heals over 90% of fissures. A small number of patients report long-term difficulty controlling flatulence, so Dr Mirbagheri weighs your obstetric history and baseline continence carefully first.
Recovery from anal fissure procedures or surgery
After botulinum toxin injection, most people return to normal activity within a day or two. Pain relief is often noticeable within a week, though full healing takes several weeks.
After fissurectomy or sphincterotomy
Expect some discomfort for 1-2 weeks. Most patients take 3-7 days away from work, longer for physically demanding jobs. Laxatives continue through the recovery period, because a hard stool in the first fortnight undoes good work. Warm baths, simple analgesia and avoiding constipation carry most of the load.
General wounds
Dr Naseem performs surgical procedures, including anal fissure repair, at St John of God and the Epworth hospitals in Melbourne, as well as offering consultations from her offices in Richmond and Berwick. If you believe that Dr Naseem is the right surgeon for your particular case, please contact us today to book an appointment.
Alternatively, use our online referral page to fill in the form and attach your referral letter and Dr Naseem’s secretary will be in touch within 24-hours to book an appointment.
For non-urgent cases, a 1-to-2-week appointment time may apply.
This page provides general information only. It isn’t a substitute for individual medical advice. Any surgical procedure carries risks, and outcomes vary between patients. Discuss your own circumstances with a qualified health practitioner.