Painful anal
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These can be treated with pain-killers such as paracetamol but the headache causes some people to stop using the medicine. Treatment with GTN often causes headache and about 20 in every 100 people using it have very bad headaches. The GTN helps the ring muscle (sphincter) to relax which allows more blood to flow to the lining of the anus (back passage) so that the cells which make up the lining can heal the fissure (or tear). GTN ointment is applied to the affected area twice a day and is used to relieve pain caused by the fissure. Glyceryl trinitrate is commonly abbreviated to GTN. Without enough oxygen, the cells which make up the lining can't grow and repair (heal) the fissure (or tear).Ī licensed medicine for treating chronic anal fissure in adults (over 18 years of age) is available in the UK: glyceryl trinitrate ointment (also called Rectogesic 4 mg/g Rectal Ointment). That means that not enough oxygen (carried by the blood) gets to the fissure (or tear). If someone has a chronic fissure, it is thought that the reason it has not healed is that the ring muscle (sphincter) that goes around the anus (back passage) has become so tense that the flow of blood to the lining of the anus is reduced. Anal fissures usually heal within a few weeks but those that have not healed after 4–6 weeks are called chronic fissures. When someone has an anal fissure the first treatments can include a high-fibre diet, laxatives and applying anaesthetic ointments to the affected area. This can cause bleeding, local itching and pain with a bowel movement, which can be severe.
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