title: Treatment of fissure in ano- revisited.
abstract: BACKGROUND
  Fissure in ano is a troubling and painful condition that affects a great majority of the population world over. The nature and anatomy of fissure in ano is quite clear, and much is known about the various predisposing and contributing factors that lead to initiation and progression of the disease. The preferred method of treating them, one that results in optimal clinical results and the least pain and inconvenience to the patient, however, has been open to debate.
  
  
  METHODS
  This paper outlines a brief account of the present scenario of different techniques available for the treatment of chronic anal fissure.
  
  
  CONCLUSIONS
  Medical manipulation of the internal sphincter should be a first-line treatment in anal fissure. When this fails or fissures recur, lateral subcutaneous internal sphincterotomy should be the preferred options for the treatment of chronic fissure in ano. Nevertheless, all the option should be presented to the patient with complete information about the method, cure rates, complications, and recurrence of the disease.
authors.affiliation: Gupta Nursing Home, D/9 Laxminagar Nagpur, India. drpjg_ngp@sancharnet.in
authors.forename: Pravid J
authors.initials: PJ
authors.lastname: Gupta
mesh_terms: D000287:Administration, Topical; D000700:Analgesics / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004032:Diet; D005401:Fissure in Ano / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D009465:Neuromuscular Agents / Q000627:therapeutic use; D009543:Nifedipine / Q000627:therapeutic use; D020030:Nitric Oxide Donors / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D002121:Calcium Channel Blockers; D054368:Laxatives; D009465:Neuromuscular Agents; D020030:Nitric Oxide Donors; D014665:Vasodilator Agents; D019274:Botulinum Toxins, Type A; D009543:Nifedipine