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Q. Can lateral internal sphincterotomy be used to treat recurring anal fissures?

Answered by
Dr. Anshul Varshney
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Jul 11, 2019

Hello doctor,

I have had reoccuring pain in my anal for about 10 years. It stays for about 2 to 4 weeks and then it is good for 1 to 4 months. First, I thought it was hemorrhoids but then a specialist diagnozed it as an anal fissure. I am 29 years old, male, eat super-healthy and exercise. I have read about all possible natural treatments and have tried them (fiber, sitz baths, etc.) but the pain always comes back.

What are my options? Would lateral internal sphincterotomy heal these reoccuring anal fissures? I also took pictures of my anal yesterday which I would like to have a specialist looking. One while a bowel movement (and bath and shower) and one the next morning.

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology


Welcome to

We are here to help you. I have evaluated your reports and medical history (attachment removed to protect patient identity). As such there is no indication for surgery at this point of time until and unless your pain frequency increases a lot. If it is happening once in 2 to 3 months for a few days then it is bearable. I do not think surgery is required.

At that time you can apply Lignocaine containing jelly for a few days and it will soothen your pain. As far your query is concerned, yes lateral sphincterectomy can help you.

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Thank you doctor,

It does not happen only for a few days, but I am in intense pain for at least 1 to 2 weeks. Sometimes, being so bad that I can hardly work my office job. Did you see any hemorrhoids present in the photos? Was there anything abnormal in the photos?

Dr. Anshul Varshney

Critical Care Physician Diabetology General Medicine Internal Medicine Medical Gastroenterology Nephrology Pulmonology (Asthma Doctors) Rheumatology


Welcome back to

Practically it is difficult to distinguish hemorrhoids in the photograph (attachment removed to protect patient identity). However, if you have such a high frequency of pain then it would be better to consider surgery. If you have any further query, please ask me.

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