Anal fissure treatment

An anal fissure can heal by itself, but in some cases it might need to be treated by having surgery. 

Surgery will be done under general anaesthetic. This means that you are asleep and do not feel anything. 

You can usually go home on the same day as your surgery and do not need to stay in hospital overnight. 

Before surgery

You need to go to a pre-assessment clinic. We can then check your health, ask you questions about your medical history and your medicines, and talk to you about the surgery in more detail. 

Having surgery

Surgery is often done as a day case under general anaesthetic. This means that you can come into hospital and leave on the same day as your surgery.  

The surgery eases the pressure and pain of your fissure, and allows it to heal. 

Surgery involves weakening the sphincter muscles on the inside of your anus. The muscles control the opening and closing of your anus. This can be done in 2 different ways:

  • by injecting botulinum toxin into the sphincter muscles
  • by surgically cutting the muscle (called a lateral internal sphincterotomy)

Your surgeon talks to you about these options, and which is the best one for you. 

Taking an unlicensed medicine

The use of botulinum toxin for treating anal fissures is unlicensed. This means that the manufacturer of the medicine has not specified it can be used in this way. However, there is evidence that the medicine works to treat this condition. 
Read our information on using unlicensed medicines

Resource number: 0914/VER7
Last reviewed: June 2023
Next review due: June 2026

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