Anal fissures are cuts in the anal canal that can occur when passing large or unwieldy bowel movements. Aside from recommending medication to ease constipation, which will ensure the stool becomes less rigid, doctors often prescribe nifedipine ointment. This medicine helps to lessen inflammation to create a more hospitable environment in which the body's natural healing process can mend the wound.
Nifedipine ointment, typically used after waking in the morning and again at night, is designed to ease the spasms and tender inflammation of the anal fissures. It eases the blood flow and allows the rectal cavity to relax, in turn promoting the healing of the tear. Another medicine that may be prescribed for this purpose is nitroglycerin.
Using nifedipine ointment requires a disinfected hand and a latex glove or an applicator nozzle. Laying on the side, with the top knee bent to the chest, the ointment can then be spread on the finger and rubbed around the anus and just inside the rectal cavity. Like hemorrhoid creams, many nifedipine ointment containers will include nozzles that easily inject the needed amount of medicine into the rectum.
Along with nifedipine ointment and a stool softener, physicians often recommend an increase in liquid and fiber consumption — both natural ways to soften the stool. In extreme cases, when pain does not subside and fissures do not heal, a doctor may recommend a Botox;® injection to further relax the rectal cavity. As a last resort, a surgical procedure called a lateral internal sphincterotomy involves removing part of the muscle forming the sphincter, which ideally improves blood flow to the rest of the anal cavity and further promotes healing.
According to the Mayo Clinic, anal fissures will heal themselves after two or three weeks. If the pain continues unabated for more than a few months, however, patients should seek medical treatment. Before it is time to see a doctor, however, common over-the-counter remedies include fiber supplements to soften the stool as well as topical ointments like nitroglycerin and zinc oxide. Another method involves sitting in a warm bath, called a sitz bath, for up to 20 minutes without adding any soap to the water since it could cause further irritation.
Anal fissures can occur not just from large stool but also from sexual activity or even conditions like Crohn's disease. Aside from pain being experienced during and after bowel movements, bright red bleeding will often be found in the toilet or on toilet paper. Itching is also common in and around the anus, which may or may not have a visible tear or lump protruding.