Although sphincterotomy has been the standard treatment for chronic fissures for over 20 years, one study found that anal dilation, using either a retractor or a balloon, helped to cure fissures in 93 and 94 per cent, respectively, and with fewer complications than surgery (Dis Colon Rectum, 1992; 35: 322-7).
There’s little scientific evidence to support the use of alternative and complementary medicine for fissures. Traditional Chinese medicine may offer symptom relief through herbs and acupuncture, while temperature-lowering products such as Anurex - biodyne plus shark liver oil - might give instant relief, even though they cannot cure the ulcer.
Perhaps the best approach is prevention rather than cure. Constipation is one of the main causes of anal fissures, and there’s plenty on offer from alternative medicine to treat it.
A number of factors can contribute to constipation, such as prolonged immobility due to bedrest, inadequate exercise, a low fibre and fluid intake, irregular eating habits and stress. Other possibilities include the use of drugs such as aluminium hydroxide antacids and antihypertensives, narcotics such as codeine and morphine, and iron supplements. Constipation can also indicate a more serious condition, such as colon cancer or diabetes, so it’s worth having it checked out.
You should drink 8-10 glasses of fluids every day. Tea and coffee can be effective laxatives, though caffeine can contribute to constipation, but should not be included in your daily count of fluids. High-fibre diets can also help - eat plenty of fresh fruits and vegetables, cooked wholegrain cereals with added bran, and foods containing wholegrains such as amaranth, quinoa, oat bran and rye (Ther Umsch, 1997; 54: 190-2).
Take more exercise; walking for half an hour after a meal can be helpful.
Things to avoid or cut down on are milk, refined sugar such as sweets and soda, and calcium-rich products; you should also reduce your iron intake.
Some practitioners find mineral oil beneficial. Helpful herbs include alfalfa, barberry, butternut root bark, cascara sagrada (not to be taken by an IBS sufferer), dandelion, flaxseed oil, ginger root, Irish moss, liquorice, Psyllium, rhubarb root, senna leaves and slippery elm. Supplements such as acidophilus and Miller’s bran may also prove helpful.