Treatment of Anal Fissure - Revisited

Fissure in ano is a troubling and painful condition that affects a great majority of the population world over. The nature and anatomy of the fissure in ano is quite clear, and much is known about the various predisposing and contributing factors that lead to initiation and progression of the disease. The preferred method of treating them, one that results in optimal clinical results and the least pain and inconvenience for the patient, however, has been open to debate. This study outlines a brief account of the present scenario of different techniques available for the treatment of chronic anal fissure. Considering all aspects, it can be concluded that medical manipulation of the internal sphincter should be a first-line treatment in anal fissure. When this fails or fissures recur, lateral subcutaneous internal sphincterotomy should be the preferred options for the treatment of chronic fissure in ano. Nevertheless, all the options should be presented to the patient with complete information about the method, cure rates, complications, and recurrence of the disease.