title: A review of conservative and surgical management of anal fissure.
abstract: BACKGROUND
  Anal fissures are one of the common perianal conditions presenting with bleeding, itching, and pain of varying severity. The method of treating this pathology should preferably be the one that results in optimal clinical outcome, is less painful, and is patient friendly. Despite a plethora of techniques in vogue, an ideal management of this condition continues to be a subject of debate.
  
  
  METHODS
  A Medline database was used to perform a literature search for articles relating to the term 'anal fissure'.
  
  
  CONCLUSIONS
  Analysis of the available literature shows that by far, medical manipulation of the internal sphincter should be the first-line treatment in anal fissure. A surgical therapy is called for if the medical therapy fails or there is a recurrence.
authors.affiliation: Gupta Nursing Home, Laxminagar, Nagpur, India. drpjg_npg@sancharnet.in
authors.forename: P J
authors.initials: PJ
authors.lastname: Gupta
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D001905:Botulinum Toxins / Q000627:therapeutic use*; D002404:Catheterization / Q000379:methods; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005401:Fissure in Ano / Q000175:diagnosis* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009543:Nifedipine / Q000627:therapeutic use; D011351:Proctoscopy / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001905:Botulinum Toxins; D009543:Nifedipine