If you've ever been to the doctor for anal fissures, chances are you were prescribed not the modern alternative, Botox, but a cylindrical suppository containing steroid like hydrocortisone.
The idea behind treating anal fissures with steroids is that the steroid will accelerate healing if the fissure is given some time to heal. And fairly frequently, they work.
Sometimes the steroid doesn't work, so the doctor tries a nitrate. These are drugs that act the same way as the erectile dysfunction drugs Viagra, Cialis, or Levitra, only they stimulate the nerve endings of blood vessels around the anus to help hold it in place so it can heal. Nitrates are usually dispensed as ointments you have to apply directly to the fissure, by hand.
Like Viagra, Cialis, and Levitra, these nitrates cause headaches for which you don't want to take aspirin, as aspirin aggravates bleeding. The herbal remedy for this kind of headache, however, is peppermint tea.
When steroids and nitrates for anal fissures don't work, the next level of treatment is usually a fissurectomy.
Most patients misunderstand this procedure. The surgeon does not "stitch up" the fissure. The surgeon cuts it out.
And when part of the anus is surgically removed, about 5 per cent of the time the result is chronic itching and burning, the formation of a fistula (essentially, a second anus), inability to urinate, or incontinence necessitating the use of adult diapers.
There had to be a better way. This may be Botox. Why Botox? Well if your anal sphincter is partially paralyzed, you certainly won't be straining.
Of course, that reality produces its own problems. And Botox can actually cause worse problems than the anal fissure, namely a thrombosed (blood filled) hemorrhoid.
So what to do about anal fissures?
The blood on the toilet tissue may be disconcerting (bright blood is always a healthier sign than dark blood, by the way), but over the long run you may get the most relief by treating constipation, and by being as relaxed as possible when you toilet.
You may also be interested in:
WASH for Anal Fissures.