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The dose is not standardized and has varied from 2. A practical algorithm that we think is evidence based and encompasses changing practice for the treatment of anal fissures is shown in Figure 3. The internal sphincter aids in continence. The main intents of medical therapy are threefold: The pain following a bowel movement may be brief or long lasting; however, the pain usually subsides between bowel movements. Overall, the procedure is safe and can be done under local anesthesia with intravenous sedation in most patients. Treatment involves the combination of diathermy fulguration of small clusters of warts or warts within the anal canal and scissor excision of more extensively involved areas.
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Modern Perspectives in the Treatment of Chronic Anal Fissures

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Anal Fistulas and Fissures: Background, Pathophysiology and Etiology, Epidemiology

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Anal Fissure Symptoms, Treatment Relief, and Cure

The anal dilator in the conservative management of acute anal fissures. Likewise, all possible infections should be diagnosed and treated prior to any operative manipulation. This article has been cited by other articles in PMC.
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