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The treatment of anal fissures has evolved over the last 5 years with the development of topical treatments aimed at reducing sphincter hypertonia.

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Treatment of children with anal fissures is slightly different from treatment of adults in that an outpatient open lateral internal sphincterotomy is the procedure of choice.

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My experience has been that botox injections, lateral internal sphincterotomy, application of nitroglycerin ointment, and other conventional medical treatments for a chronic anal fissure tend to lead to temporary healing at best and a re-occurrence of the fissure if emotional stress continues to take its toll on the internal anal sphincter.

After 2 operations in the last 2 weeks the pain is better but i am still left with this fissure.

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