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. This trauma has been associated with a variety of causes, but most often is simply the result of a hard stool.

Possible Symptoms

• Pain
• Anal itching
• Localized pain during bowel movements
• Bright red blood in stool

What Causes Anal Fissure Pain?

• The initial pain of an anal fissure will cause the internal anal sphincter muscle to tighten and go into spasm.
• This spasming of the sphincter muscle aggravates the fissure causing extreme pain during and after a bowel movement.
• The tightening/spasming of the sphincter muscle also restricts blood flow to the affected area, which delays healing.

How to Eliminate Fissure Pain 

The key to anal fissure pain relief is keeping the Internal Anal Sphincter Muscle in a relaxed state. Keeping the Internal Anal Sphincter Muscle relaxed and preventing spasm will significantly reduce pain and improve blood flow to the affected area to promote healing. Patients comment that after using DoseRite, they think their fissure is healed after the first few days because their pain is gone. The goal is to keep patients pain-free while their fissure heals (usually 4-6 weeks to heal).

What Medications Are Being Used?

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 (soft lining of the anal canal) where it can be absorbed by the internal anal sphincter muscle.

KEY POINTS:

• Rubbing the medication on the outside of the anus is not effective at reaching internal anal sphincter muscle.
• Intra-anal application makes a difference. Most patients don’t want to or can’t insert their finger into their fissured anus.
• Getting the correct dose is also important. A pea-size amount is not enough to relax the internal sphincter muscle.