Management of Chronic Anal Fissures: Review Article

Abstract

Chronic anal fissure is a common and distressing anorectal condition characterized by severe pain, bleeding during defecation, and impaired quality of life. Unlike acute fissures, chronic fissures are associated with persistent internal anal sphincter hypertonia, ischemia, and secondary structural changes such as sentinel piles and hypertrophied anal papillae. Multiple therapeutic strategies have been proposed, ranging from conservative medical therapy to surgical interventions, with ongoing debate regarding the optimal balance between healing efficacy and the risk of complications, particularly fecal incontinence. This review aimed to review and evaluate current medical and surgical management options for chronic anal fissures, focusing on their effectiveness, safety profiles, and clinical outcomes.