Anal Fissure



  • Advise increase fluid intake and adequate dietary fibre intake by eating a balanced diet containing whole grains, fruits, and vegetables, gradually to minimize flatulence and bloating.
  • Keep anal region clean and dry to aid healing and avoid complications of anal fissure (such as infection or abscess)
  • Children: If not resolved after 2 weeks or if a lot of pain seek specialist advice/refer to a paediatrician


  • Paracetamol or ibuprofen. Avoid opioid analgesics as they can cause constipation
  • Sitting in a shallow, warm bath several times a day may help 
  • topical anaesthetic (lidocaine 5% ointment) apply 1–2 mL when required before passing a stool


  • Rectal glyceryl trinitrate (GTN) 0.4% ointment twice a day for 6–8 weeks
    • Only prescribe if symptoms for 1 week or more without improvement
    • Around 25% of people experience headache as a side effect
    • Avoided in children, and during pregnancy and breastfeeding
    • If anal fissure unhealed after 6–8 weeks but the person is asymptomatic or has had notable symptomatic improvement, consider a second course of rectal GTN
    • Refer to colorectal surgery

Patient Information 

Anal Fissure - NHS


    • If at any time an anal fissure appears atypical or scarring or skin tags develop — refer to secondary care for further investigation and management.

© 2023 | WellBN Ltd

Press enter to search

If you are involved in the prescribing process, then AskShilpa has been created for you!

01273 772020
18-19 Western Rd, Hove BN3 1AE

Shilpa's Words

We love