A trial of a high residue diet and avoidance of constipation (aim for soft bulky stools) may lead to resolution. A combined local anaesthetic and corticosteroid ointment applied to the fissure can provide relief and promote healing. Hot baths relax the internal anal sphincter. The most promising conservative treatment is the application of glyceryl trinitrate ointment (Nitro-bid 2% ointment) diluted 1 part with 9 parts of white soft paraffin twice daily to the lower anal canal. 2

Lateral internal sphincterotomy is indicated in patients with a recurrent fissure and a chronic fissure with a degree of fibrosis and anal stenosis. This surgical procedure is very effective. An alternative is injection of botulinum toxin into the sphincter.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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