Anal Fissures are a Pain in the Butt!
Causes, Symptoms & Options to Address Anal Fissures
What’s an Anal Fissure?
An anal fissure is a small tear in the thin tissue (mucosa) that lines the anal canal. Anal fissures are typically the result of some form of trauma to the anus—most often from passing a hard stool.
Possible Symptoms
- Pain
- Anal itching
- Localized pain during bowel movements
- Bright red blood in stool
At Town & Country Compounding, we work with the patient and the practitioner to offer other options for patients in the Northern New Jersey & NYC areas.
Schedule a ConsultationWhat Causes Anal Fissure Pain?
- The initial pain of an anal fissure can cause the internal anal sphincter muscle to tighten and go into spasm.
- This spasm aggravates the fissure, causing extreme pain during and after a bowel movement.
- The tightening/spasm can also restrict blood flow to the area, delaying healing.
How to Eliminate Fissure Pain
The key to anal fissure pain relief is keeping the internal anal sphincter muscle in a relaxed state. Preventing spasm can significantly reduce pain and improve blood flow to promote healing.
Patients often report that after using DoseRite, their fissure feels “healed” after the first few days because their pain is gone. The goal is to keep patients pain-free while the fissure heals (usually 4–6 weeks).
DoseRite Applicator for the Anal Canal
Topical calcium channel blockers (e.g., nifedipine, diltiazem) work by relaxing the sphincter muscle and increasing blood supply to the fissure. They are designed to be applied to the anal mucosa (the soft lining of the anal canal) where they can be absorbed by the internal anal sphincter muscle.
Key Points
- Rubbing medication on the outside of the anus is not effective for reaching the internal anal sphincter muscle.
- Anal canal application makes a difference—most patients don’t want to (or can’t) insert a finger due to pain.
- Getting the correct dose matters; “pea-size” is often not enough to relax the internal sphincter muscle.
Note from Town & Country Compounding: Compounded formulations are often prescribed because certain drugs are not commercially available in a topical form or in combination form. For example, nifedipine—normally an oral drug—can be compounded into a rectal ointment. It is also common for a prescriber to request that something for pain be added into the formulation (e.g., nifedipine + lidocaine).
DoseRite Applicator for the Anal Canal
(Available at Town & Country Compounding with your Rx)
- The goal of DoseRite is to eliminate pain while the fissure heals.
- Its closed-end design is intended to deliver medication within the anal canal, not the rectum.
- Medication is absorbed by the anal mucosa (soft tissue surrounding the internal sphincter muscles).
- Anal canal application with DoseRite can improve pain relief compared with peri-anal finger application.
- Anal canal application may reduce side effects such as headaches in patients using nitroglycerin (NTG).1
- Side slots deliver medication along the length of the tip.
- A safety flange helps ensure insertion to a safe depth.
