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How the Medications Work

When you have an anal fissure, the first line of treatment is almost always the same: you either get an anesthetic cream, some kind of lubricant, a laxative or a combination of those three. Let’s take a closer look at how they work.

Creams that contain anesthetics actually don’t do anything, except ease the pain caused by a fissure. They will not heal your fissure or prevent it from reoccurring.

Lubricants and laxatives, on the other hand, try to help your fissure to heal. They do that, by reducing the chances of further injury to the anal canal (a lot of times these injuries occur during bowel movements). Lubricants ease the passage of stool (by lubrication, obviously), while laxatives try to make the stool softer.

Medications for More
Severe - Chronic Fissures

These medications can be divided into 2 different groups. The first group is:

Medications that relax your internal anal muscle

The muscle in your anal canal is called the internal anal sphincter. This muscle is very important, as it helps you control the passing of stool (by squeezing itself, it is preventing the stool from leaking out).

When you have a bowel movement, this muscle should relax. If you have an anal fissure, however, this muscle goes into spasm. It starts squeezing much harder than it should, which makes the passing of stool more difficult.

As a result, every time you have a bowel movement, the tissue in your anal canal tears a little. So, your anal fissure is getting bigger, instead of smaller.

Medications, such as botulinum toxin, will help you relax your internal sphincter. This will give your fissure a time to heal. Botulinum toxin is commercially sold under a more familiar name – Botox.

Medications that increase the flow of blood to the anal canal

Doctors discovered that when people have anal fissure, the blood supply to the rectum and the anal canal is reduced (they found out about this while performing post-mortem examinations on people who had anal fissure – don’t worry, fissure is not fatal – these people died from some other condition).

Because of this discovery, the doctors figured that if you increase the flow of blood to the anal canal, the fissure will heal. That is, basically, what medications, such as calcium channel blockers and nitroglycerin, do (usually, these same medications are used for regulating blood pressure and treating heart conditions).

These medications all sound great, but there is one fact you should be aware of: the recurrence rate of fissures is the same whether you take these medications or use a simple placebo. So, none of these medications will make sure that you don’t develop another fissure in the future.

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