For fissures in infants:

• - Change diapers frequently.
• - Treat constipation, if that is found to be the cause.
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For fissures in adults:

Ø  Keep the anorectal area dry.

Ø  Wipe the area with soft materials, a moistened cloth, or cotton pad. Avoid rough and scented toilet paper.

Ø  Promptly treat all occurrences of constipation and diarrhea.

Ø  Avoid irritating the rectum.

Ø  Get plenty of fiber: If you're constipated, passing large, hard, or dry stools can cause an anal fissure. Getting plenty of fiber in your diet -- especially from fruits and vegetables -- can help prevent constipation, though.

• - Wheat bran
• - Oat bran
• - Whole grains, including brown rice, oatmeal, popcorn, and - whole-grain pastas, cereals, and breads
• - Peas and beans
• - Seeds and nuts
• - Citrus fruits
• - Prunes and prune juice
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If you can’t get enough fiber through your diet, try fiber supplements.

Whether you eat more fiber-rich foods or take supplements, boost your intake gradually until you notice softer, more-frequent bowel movements. Also, drink plenty of liquids as you take in more fiber. This will help you avoid bloating and gas.

Ø  Stay hydrated. That can help you prevent constipation. Drinking plenty of liquids adds fluid to your system, which can make stools softer and easier to pass. Be sure to drink more when the weather gets warmer or as you become more physically active.

Foods that are beneficial for anal fissure:

- Wheat bran.

- Oat bran.

- Whole grains, including brown rice, oatmeal, popcorn, and whole-grain pastas, cereals, and breads.

- Peas and beans.

- Seeds and nuts.

- Citrus fruits.

- Prunes and prune juice

When to consult a doctor for anal fissure treatment?

If you have an anal fissure, you may be referred to a doctor who specializes in digestive diseases (gastroenterologist) or a colon and rectal surgeon.

Treatment option & cost

Non- surgical treatments

• - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe.
• - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
• - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms.
• - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects.
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Surgical treatments for anal fissure

If your anal fissure does not go away with medicinal treatments or any other treatment methods, it could be an indication of chronic anal fissure. In that case, the proctologist may recommend you undergo surgery for permanent treatment for anal fissure. 

- Open surgery – In open surgery, the anorectal surgeon makes a small incision in the anal sphincter to relax the anal muscle. Once the muscle is relaxed, it lets the anal fissure heal. Open anal fissure surgery is a conventional treatment procedure that comes with a certain amount of risks and complications, permanent incontinence being the most common one. 

- Laser surgery – During the procedure, the fissure doctor first administers local or general anesthesia to the patient. The doctor uses a laser probe to emit infrared radiation or laser beams at the surgical site [location of anal fissure]. The high-energy laser beams increase the blood flow to the area of the fissure and promote quick and proper healing of the fissure.

Preparation for anal fissure surgery

Before undergoing the surgery, it is important to make sure that you follow all the tips and advice from the doctor. Some of the tips for surgery preparation may include the following:

It is highly likely that the fissure doctor will tell you everything about the treatment procedure. All you need to do is follow the instructions diligently. If you are allergic to any medication, let the doctor know in advance.

• - Quit drinking alcohol and smoking cigarettes at least a week before the surgery. This will help you recover and heal after the surgery quicker and in a much efficient manner. 
• From the night before the surgery date, try to avoid eating heavy or large meals.
• - On the day of the surgery, leave your valuable items at home while coming to the hospital.
• - Get someone along with you while coming to the hospital for surgery who can help you drive home as you will not be allowed to drive.
• - Get answers to all your questions about the surgery from the attending doctor or the surgeon.
• - Before undergoing surgery, make sure either you or your guardian signs the consent form.
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What to except after the surgery

Sphincterotomy, you may experience some mild to moderate pain or discomfort in your rectal area.You may also experience constipation, difficulty urinating, and possibly some rectal bleeding. The following are some general guidelines for proper care after your procedure.

After the anal fissure surgery

Avoid strenuous activity for 1 week after your procedure. Take sitz baths (sit for 15-20 minutes in warm water) three times a day and after each bowel movement for the first few days. Don't worry if you have some bleeding, discharge, or itching during your recovery. This is normal.

Recovery time line

It is important to note that complete healing with both medical and surgical treatments can take up to approximately 6-12 weeks. However, acute pain after surgery often disappears after a few days. Most patients will be able to return to work and resume daily activities a few short days after the surgery.