Anal Fissure Questions & Answers

1. Nzimbala MJ, Bruyninx L, Pans A, Martin P, Herman F. Chronic anal fissure: common aetiopathogenesis, with special attention to sexual abuse. Acta Chir Belg. 2009 Nov-Dec. 109 (6):720-6. [QxMD MEDLINE Link].

2. Farid M, El Nakeeb A, Youssef M, Omar W, Fouda E, Youssef T, et al. Idiopathic hypertensive anal canal: a place of internal sphincterotomy. J Gastrointest Surg. 2009 Sep. 13 (9):1607-13. [QxMD MEDLINE Link].

3. Grucela A, Salinas H, Khaitov S, Steinhagen RM, Gorfine SR, Chessin DB. Prospective analysis of clinician accuracy in the diagnosis of benign anal pathology: comparison across specialties and years of experience. Dis Colon Rectum. 2010 Jan. 53 (1):47-52. [QxMD MEDLINE Link].

4. Abramowitz L, Benabderrahmane D, Baron G, Walker F, Yeni P, Duval X. Systematic evaluation and description of anal pathology in HIV-infected patients during the HAART era. Dis Colon Rectum. 2009 Jun. 52 (6):1130-6. [QxMD MEDLINE Link].

5. [Guideline] Davids JS, Hawkins AT, Bhama AR, Feinberg AE, Grieco MJ, Lightner AL, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures. Dis Colon Rectum. 2023 Feb 1. 66 (2):190-199. [QxMD MEDLINE Link]. [Full Text].

6. [Guideline] Wald A, Bharucha AE, Limketkai B, Malcolm A, Remes-Troche JM, Whitehead WE, et al. ACG Clinical Guidelines: Management of Benign Anorectal Disorders. Am J Gastroenterol. 2021 Oct 1. 116 (10):1987-2008. [QxMD MEDLINE Link]. [Full Text].

7. Schiano di Visconte M, Munegato G. Glyceryl trinitrate ointment (0.25%) and anal cryothermal dilators in the treatment of chronic anal fissures. J Gastrointest Surg. 2009 Jul. 13 (7):1283-91. [QxMD MEDLINE Link].

8. Nitroglycerin rectal ointment (Rectiv) [package insert]. ProStrakan. June 2011. Available at [Full Text].

9. Samim M, Twigt B, Stoker L, Pronk A. Topical diltiazem cream versus botulinum toxin a for the treatment of chronic anal fissure: a double-blind randomized clinical trial. Ann Surg. 2012 Jan. 255 (1):18-22. [QxMD MEDLINE Link].

10. Sileri P, Stolfi VM, Franceschilli L, Grande M, Di Giorgio A, D'Ugo S, et al. Conservative and surgical treatment of chronic anal fissure: prospective longer term results. J Gastrointest Surg. 2010 May. 14 (5):773-80. [QxMD MEDLINE Link].

11. Abd Elhady HM, Othman IH, Hablus MA, Ismail TA, Aboryia MH, Selim MF. Long-term prospective randomised clinical and manometric comparison between surgical and chemical sphincterotomy for treatment of chronic anal fissure. S Afr J Surg. 2009 Nov. 47 (4):112-4. [QxMD MEDLINE Link].

12. Shao WJ, Li GC, Zhang ZK. Systematic review and meta-analysis of randomized controlled trials comparing botulinum toxin injection with lateral internal sphincterotomy for chronic anal fissure. Int J Colorectal Dis. 2009 Sep. 24 (9):995-1000. [QxMD MEDLINE Link].

13. Rather SA, Dar TI, Malik AA, Rather AA, Khan A, Parray FQ, et al. Subcutaneous internal lateral sphincterotomy (SILS) versus nitroglycerine ointment in anal fissure: a prospective study. Int J Surg. 2010. 8 (3):248-51. [QxMD MEDLINE Link].

14. Mousavi SR, Sharifi M, Mehdikhah Z. A comparison between the results of fissurectomy and lateral internal sphincterotomy in the surgical management of chronic anal fissure. J Gastrointest Surg. 2009 Jul. 13 (7):1279-82. [QxMD MEDLINE Link].

Lisa Susan Poritz, MD Associate Professor of Surgery and Cellular and Molecular Physiology, Director, Colon and Rectal Research, Department of Surgery, Division of Colon and Rectal Surgery, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine

Lisa Susan Poritz, MD is a member of the following medical societies: American College of Surgeons, American Physiological Society, Central Surgical Association, Society of University Surgeons, Association of Women Surgeons, American Society of Colon and Rectal Surgeons, Association for Academic Surgery, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

David L Morris, MD, PhD, FRACS Professor, Department of Surgery, St George Hospital, University of New South Wales, Australia

David L Morris, MD, PhD, FRACS is a member of the following medical societies: British Society of Gastroenterology

Disclosure: Received none from RFA Medical for director; Received none from MRC Biotec for director.

John Geibel, MD, MSc, DSc, AGAF Vice Chair and Professor, Department of Surgery, Section of Gastrointestinal Medicine, Professor, Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director of Surgical Research, Department of Surgery, Yale-New Haven Hospital; American Gastroenterological Association Fellow; Fellow of the Royal Society of Medicine

John Geibel, MD, MSc, DSc, AGAF is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, Society for Surgery of the Alimentary Tract

Disclosure: Nothing to disclose.

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