Question

Standard treatment guidelines for anal fissure

Answer 1

 2014 American College of Gastroenterology clinical guideline on the management of benign anorectal disorders made the following recommendations for anal fissure [11] :

Acute anal fissure - Providers should use nonoperative treatments (eg, sitz baths, psyllium fiber, and bulking agents) as the first step in therapy (strong recommendation, moderate-quality evidence)

Chronic anal fissure - Providers should treat chronic anal fissure with topical pharmacologic agents (eg, calcium channel blockers or nitrates) (strong recommendation, moderate-quality evidence)

Chronic anal fissure - Providers should refer patients who do not respond to conservative or pharmacologic treatment for local injections of botulinum toxin (strong recommendation, low-quality evidence) or internal anal sphincterotomy (strong recommendation, high-quality evidence)

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. hope it helps
.BE BRIGHT, BE BRIANLY!

Answer 2

Answer:

almost half of all patients who have acute anal fissure will resolve their symptoms with nonoperative measures such as sitz baths and the use of psyllium fiber or other bulking agents, with or without the addition of topical anesthetics or topical steroids.