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An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. recurrent anal fissure following sphincterotomy is a rare, but very troubling problem, since one must be very careful to avoid the sphincter damage and incontinence that is associated with. An anal fissure is a small tear or crack in the lining of the anus. If you experience severe pain or bright red bleeding during or after bowel movements, you may have an anal fissure. People with inadequate adherence to dietary and lifestyle measures. This recommendation is based on what cks considers to be good clinical practice. Evidence from a cochrane systematic review (search date august 2010). The most common symptoms of anal fissures are a sharp pain when you poo, often followed by a deep burning pain that may last several hours bleeding when you poo most people notice a small amount of bright red blood either in their poo or on the toilet paper when to see a gp. I use gtn twice a day, stool softeners, and drink plenty of water. Herman hammerstead surgery you sound like a good candidate for a lateral sphincteromyoto. Most anal fissures should heal after just a few weeks, but if you have recurring anal fissures or a fissure that lasts for 4-6 weeks, that could be the sign of a chronic inflammatory bowel disease. chronic anal fissure represents one of the most painful diseases occurring in the anorectal area. Cure requires removal of all abnormal tissue and is primarily a surgical problem. The surgeon learns early in his career that some of the most grateful. An anal fissure (fissure-in-ano) is a small, oval shaped tear in skin that lines the opening of the anus. Fissures typically cause severe pain and bleeding with bowel movements. An acute anal fissure may heal spontaneously or in response to medical therapy with warm baths, stool softeners, bulk laxatives, analgesics, topical anaesthetics and re-assurance. 1 dietary bran supplements and warm sitz baths are superior to topically applied, local anaesthetic or hydrocortisone cream 2 and fibre ingestion results in fewer recurrences.