How to treat secondary anal fissure

Treatments for secondary anal fissures include medication, lifestyle adjustments, and surgery, and the specific choice depends on the severity of the condition. Secondary anal fissures are usually caused by chronic constipation, diarrhea, anal infection, or trauma, and treatment should be targeted at the cause.

1. Drug treatment is the first choice for secondary anal fissures and is suitable for mild to moderate symptoms. Topical application of nitroglycerin ointment or calcium channel blockers such as diltiazem ointment can help relax the anal sphincter, improve local blood circulation, and promote healing of the fissure. Oral analgesics such as ibuprofen or acetaminophen can relieve pain. The use of stool softeners such as lactulose or docusate sodium can reduce friction and pain during defecation.

2. Lifestyle adjustment is crucial for the treatment of secondary anal fissure. Increasing dietary fiber intake, such as eating more whole grains, vegetables and fruits, can help soften stools and reduce pressure during defecation. Drinking enough water every day to keep the body hydrated can prevent constipation. Avoiding sitting or standing for long periods of time and regularly doing moderate exercise, such as walking or yoga, can help improve intestinal motility.

3. For secondary anal fissures that are ineffective with drug treatment or have severe symptoms, surgical treatment may need to be considered. Common surgical methods include internal anal sphincterotomy, which partially cuts off the internal anal sphincter to reduce anal pressure and promote healing of the fissure. Another option is anal flap surgery, which is suitable for patients with chronic anal fissures or anal stenosis. Laser treatment or radiofrequency ablation can also be used to relieve symptoms and reduce postoperative complications.

Treatment for secondary anal fissures needs to be individualized based on the cause and severity of symptoms. Mild symptoms can be improved with medication and lifestyle adjustments, while severe or chronic cases may require surgical intervention. Regardless of the treatment you choose, you should follow your doctor's advice and pay attention to preventing recurrences and maintaining good bowel habits and dietary habits.