A fissure is a small tear of the skin around the back passage. They can be very painful and can bleed. In general they are caused by constipation and straining, however they can just occur with no cause.
The simplest treatment is to use a cream (Diltiazem ointment) which relaxes the muscle and heals the fissure in about 6 out of 10 cases. If this doesn’t work then the next step is to inject Botox (under anaesthetic) to the muscle on either side.
If this doesn’t work then we can talk about performing a slightly bigger operation to divide a small amount of the sphincter muscle. This works very well but does risk incontinence so we would have to have a careful discussion before embarking on this.
If you want to discuss these treatments then please contact my secretary to book an appointment.
Rob is a Consultant Colo-Rectal Surgeon at the Royal Devon and Exeter NHS Foundation Trust and also sees patients privately at Exeter Nuffield - contact firstname.lastname@example.org 01392 262183