Is surgery a need for chronic anal fissures?

Is surgery a need for chronic anal fissures

Chronic anal fissures are a common condition that affects the anal canal. However, the tears on the lining of the anus do not heal on their own.

Such conditions require immediate attention, and treatment for a chronic anal fissure problem depends on various factors, including the severity and duration of symptoms, response to non-surgical treatments, and overall health conditions.


  1. Pain during and after bowel movements, which can last for several hours
  2. Bleeding, usually during or after a bowel movement
  3. Itching or burning around the anus
  4. A small lump near the fissure
  5. Tenderness or discomfort in the anal area
  6. Constipation or difficulty passing stool


If you are facing any of these symptoms, the first thing to consider is seeking a diagnosis from a Fissure specialist in Chennai. Based on the diagnosis, your specialist will recommend the appropriate fissure treatment in Chennai. While it may vary from surgical to non-surgical options, some common treatments for fissures include:

  • Lifestyle modifications: Avoiding constipation, maintaining good hygiene, and staying hydrated can help prevent and heal fissures.
  • Topical medications: Over-the-counter creams or ointments containing analgesics, anaesthetics, or steroid medications can help alleviate pain and inflammation.
  • Sitz baths: Soaking the affected area in warm water can help reduce pain, relax the muscles, and promote healing.
  • Dietary changes: Eating a high-fibre diet and avoiding spicy foods can help prevent constipation and reduce discomfort.
  • Surgery: In severe cases where other treatments are ineffective, surgery may be necessary to repair the fissure.
  • Laser treatment: Laser treatment of fissures can be used to treat anal fissures by promoting healing and reducing pain. During the procedure, a focused beam of light is used to create a controlled burn around the edges of the fissure, which triggers the growth of healthy new tissue.

Is surgery necessary?

In general, surgery is considered a last resort for the treatment of chronic anal fissures and is typically only recommended after conservative treatments have failed to provide relief. It may also be recommended when chronic anal fissures have persisted for longer than 8-12 weeks. Some surgeries include:

  • Lateral internal sphincterotomy: This is a surgical procedure in which the internal anal sphincter muscle is partially divided, which helps to reduce the pressure on the anal fissure and promote healing.
  • Anal advancement flap: This procedure involves using healthy tissue from the rectum to cover the fissure and promote healing.
  • Fissurectomy: This is a procedure in which the fissure is removed, and healthy tissue is allowed to grow in its place.
  • Botulinum toxin injection: Injections of botulinum toxin can be used to temporarily paralyze the anal sphincter muscle, which can help to promote healing of the fissure.

Surgery for chronic anal fissures is generally safe and effective, but it does carry some risks, such as infection, bleeding, and incontinence. It is important to discuss the risks and benefits of surgery to determine if it is suitable for a particular condition.

Dr. Karthik Gunasekaran