What is a common treatment for an anal fissure?

The common treatment for an anal fissure is the use of topical glyceryl trinitrate (GTN) or diltiazem. These medications work as muscle relaxants that effectively alleviate the internal anal sphincter spasm, which is a contributing factor to the pain and discomfort associated with fissures. By relaxing the sphincter muscle, they promote healing of the fissure and reduce pain during defecation.

Topical GTN in particular increases blood flow to the area, fostering healing while also providing pain relief. Diltiazem is a calcium channel blocker that achieves a similar effect by inhibiting calcium influx in the muscles, leading to relaxation.

While topical steroids can reduce inflammation, they are not typically the first-line treatment for fissures. Surgical resection is generally reserved for chronic or unresponsive cases, and oral antibiotics are not necessary unless there is a secondary infection, as anal fissures are not typically caused by infection. Hence, the use of topical GTN or diltiazem stands out as the standard initial approach for treating anal fissures effectively.