Anal fissures are among the conditions that are often delayed in seeking medical attention due to embarrassment and negatively impact daily life. This places significant physical and psychological strain on those affected.

Although anal fissures are quite common in society, most people mistake this condition for a simple irritation and delay visiting a doctor. However, if the fissure, which occurs for various reasons, is not treated, it becomes chronic over time and turns into a problem that negatively affects daily life. Dr. Tuğba Balkaya Tunçel, General Surgeon at Medline Adana Hospital, provides important information, stating that the disease can be treated without surgery.

It starts with a small tear

Anal fissures usually start with a small tear in the skin around the anus, caused by constipation, hard stools, or straining after childbirth. The problem manifests itself as pain, bleeding, and burning during bowel movements, similar to a glass cut. Initially, the pain may cause the person to avoid going to the toilet; this increases constipation, causing the tear to deepen and creating a vicious cycle. As a result, spasms develop in the anal sphincter muscles over time, reducing blood flow to the area and making it difficult for the wound to heal.

It can be treated without surgery

In the past, surgical methods, particularly muscle-cutting operations known as ‘sphincterotomy,’ were frequently used to treat anal fissures. However, due to the risk of gas or faecal incontinence after surgery, non-surgical treatment methods have become popular in recent years. One of the most effective and safest of these methods is Botox injection. Botox treatment for anal fissures has become one of the gold standard approaches today due to its non-surgical nature, quick application, and high recovery rate.

No general anaesthesia required

Botox is a neurotoxic protein that has been used safely in medicine for many years. Nowadays more commonly associated with cosmetic surgery, Botox is used in anal fissure treatment to temporarily relax the muscles. This injection, administered in very small doses into the anal region, eliminates muscle spasms, thereby increasing blood flow to the fissure area and allowing the wound to heal on its own. The procedure takes approximately 5-10 minutes and is usually performed under local anaesthesia. Patients can return home the same day.

Recovery in 4-8 weeks

After Botox treatment, most patients feel significant relief within a few days. Pain decreases, and the fear of going to the toilet disappears. The fissure heals completely within an average of 4-8 weeks. Moreover, there are no incisions, stitches or surgical scars during this process. The effect of the closure lasts 3 to 6 months; during this time, the fissured area is usually completely closed. However, in patients who achieve partial success within 30 days, i.e. those whose symptoms are reduced by half, a second session of Botox injection may be necessary.

Personalised treatment is planned

As with any disease, a personalised approach is required for the treatment of anal fissures. While Botox treatment alone is sufficient for some patients, additional medication or lifestyle changes may be necessary in advanced cases. Drinking plenty of water, eating a diet rich in fibre, avoiding constipation and establishing regular toilet habits are factors that increase the success of treatment.