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Q. The big wound in my anal fissure is curing, while the small wounds do not. Please suggest.

Answered by
Dr. Sandeep V Nair
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 03, 2020 and last reviewed on: Nov 07, 2020

Hello doctor,

I have anal fissures for the past seven weeks, the big wound is curing, but the small wound remains uncured. I have a previous history of these same issues ten years back. I am currently taking Fidonal ointment and antibiotics, which cured only 80% of my wound.

#

Hi,

Welcome to icliniq.com.

An anal fissure is a wound in the anal canal caused by various reasons such as overactive anal sphincter pressure, passing hard stools, straining at defecation, and rarely also in Crohn's disease. I hope the doctor has evaluated you for the same. Usually, anal fissures take at least two months to heal. It may assume longer if you continue to pass hard stools.

I need to know a few more details.

1. Are you taking stool softeners or laxatives?

2. Is there any history of recurrent abdominal pain?

3. Is there any fever?

4. Are you doing a Sitz bath?

If the answers are no to all of the above, then follow these,

  • Continue Fidonal (Lidocaine and Nifedipine) ointment thrice daily.
  • Sitz bath (immersing anus in a tub with lukewarm water with salt twice daily).
  • Use Lactifibre (Lactitol Monohydrate and Ispaghula husk)two scoops in one glass of water at night daily.
  • Drink at least 2.5 liters of water daily.

If the answer to questions 2, 3 is yes, then consult a gastroenterologist in person.

Regards.

Hi doctor,

Thanks for your reply.

I do not have any symptoms except pain, stool softeners, and laxatives were not working, so I was trying enema if possible; I need a proper antibiotic to cure anal fissure. Big wounds are curing, but small portions are remaining.

#

Hi,

Welcome back to icliniq.com.

Stool softeners and laxatives are required for healing. You have to use them regularly for the wound to heal. You have to continue using it even after the wound heals so that it does not recur. It will heal on its own. It is a non-sterile area, and local antibiotics will not work. You can try a Sitz bath. If pain is unbearable or is not healing even after two months, surgery is a better option. This can achieve a complete cure.

Regards.

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