Anal fissures are painful splits in the lining of the anus. This typically occurs with straining and stretching, but can be associated with IBD.
Treatment options fall into 3 main categories.
1) Stool softening – High fluid and soluble fibre intake +/- Osmotic laxatives eg. Movicol
2) Muscle relaxants – Diltiazem 2% ointment bd + GTN 0.4% ointment bd (Rectogesic)
3) Analgesics – Proctosedyl (cinchocaine 0.5%) ointment bd or Xyloproct (lidocaine 5%) ointment bd