How do I get treatment

For London Colorectal please telephone:

  • +44 (0) 20 7403 6061

For Gastroenterology please call:

  • +44 (0) 20 7234 2292


Patient advice following a Repair of Anal Fissure

An anal fissure is a small tear in the skin around the back passage. This can happen without any obvious cause however can often be as a result of constipation or diarrhoea. They are extremely painful, especially in the initial acute attack and can cause bleeding.

First line treatment for anal fissures is usually with a cream either 2% Diltiazem or GTN which causes the muscles around the back passage to relax and increases blood supply to that area allowing the anal fissure to heal in over half of suffers. It is important that this cream should be applied sparingly as this can cause severe headaches. Wash your hands well following application as this can be absorbed. If this fails then surgery will be required.

Injection of Botulinum Toxin (Botox)

This is a relatively new technique that involves the injection of Botulinum Toxin, known as Botox into the internal anal sphincter muscle. The Botox causes paralysis of the internal anal sphincter within a few hours of the injection. It also causes a weakening of the muscle for 3-4 months which allows the fissure to heal.

Post Operation

  • Continue to take pain relief if required however hopefully due to the procedure you will find that these will not be required.
  • It is important not to get constipated therefore you may be advised to take laxatives following the procedure in order to prevent this.
  • Ensure you eat a healthy balanced diet including plenty of fresh fruit and vegetables. Ensure you drink plenty of fluids.