Anal Fissure

Question 1

First line Treatment of Chronic anal fissure (more than one week)

Answer 1

Topical glyceryl trinitrate

Question 2

risk factors of anal fissure

Answer 2

Risk factors

constipation

inflammatory bowel disease

sexually transmitted infections e.g. HIV, syphilis, herpes

Question 3

feature of anal fissures

Answer 3

Features

painful, bright red, rectal bleeding

around 90% of anal fissures occur on the posterior midline.

if the fissures are found in alternative locations then other underlying causes should be considered e.g. Crohn’s disease

Question 4

First line Treatment of Acute anal fissure (less than one week)

Answer 4

soften stool

lubricants such as petroleum jelly may be tried before defecation

topical anaesthetics

analgesia