Techniques in Coloproctology

, 11:209 | Cite as

A review of chronic anal fissure management

  • E. E. Collins
  • J. N. Lund


Anal fissure management has rapidly progressed in the last 15 years as our understanding of fissure pathophysiology has developed. All methods of treatment aim to reduce the anal sphincter spasm associated with chronic anal fissures. Surgical techniques have been used for over 100 years with success. Lateral internal sphincterotomy remains the surgical treatment of choice for many practitioners. Postoperative impairment of continence remains controversial. Recently, less invasive methods of treatment have been explored. Topical nitrates, calcium channel blockers and botulinum toxin are established treatments. These and other non-surgical treatments are described in this review. Various guidelines and treatment algorithms for anal fissure are also discussed.

Key words

Anal fissure Fissure in ano Sphincterotomy Anal stretch Anal dilatation Nitrate Glyceryl trinitrate Calcium channel blocker Botulinum toxin 


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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of Nottingham Medical School at Derby Derby City General HospitalDerbyUK

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