Summary of Treatments for Anal Fissures

Abstract

In this series, specialist authors show general pathogenesis and treatments and some itemized discussions for anal fissures.
Atypical undermining ulcers of the anus are suspected of STD or IBD etc.
Some authors point out that chronic fissures are in consequence of acute rupture of the anus. However pathogenesis of chronic fissure is related with intra-anal pressure, especially maximum resting pressure and circulation superior to repeated physical rupture.
I show a branch-chart of general treatment of anal fissures in Japan compared with St. Mark's Hospital in England.
There might not be an appropriate word for NTG ointment therapy, however a term of chemical sphinctero-tomy is not correct and I think it is a conservative treatment in my opinion.