What is anal fissure?
An anal fissure is a small tear in the lining of the anal canal, usually caused by passing hard stools. It triggers a cycle of pain and spasm in the anal muscle, which reduces blood flow and stops the tear from healing.
Acute fissures often heal within a few weeks with fibre, stool softeners, sitz baths and healing ointments. When a fissure becomes chronic — with a sentinel tag or exposed muscle — a minimally invasive procedure that relaxes the tight muscle allows it to heal.
Symptoms & when surgery is needed
How it is diagnosed
- Gentle clinical examination — often diagnostic
- A careful history of bowel habits and pain pattern
- Proctoscopy when tolerated, to exclude other causes of bleeding
- Rarely, examination under anaesthesia for very painful or atypical fissures
Treatment options
Medical management
Fibre, stool softeners, sitz baths and muscle-relaxant ointments heal most acute fissures without surgery.
Botox injection
A calibrated injection relaxes the anal sphincter to allow healing, avoiding any cut.
Laser sphincterotomy
A precise laser releases the tight muscle and treats the fissure with minimal pain and quick recovery.
Lateral internal sphincterotomy
A time-tested day-care operation for chronic fissures resistant to other measures.
The procedure, step by step
- 1
Trial of medical therapy
Most fissures are first treated with diet, ointments and sitz baths for a few weeks.
- 2
Day-care admission
If surgery is needed, it is a short day-care procedure under spinal or short general anaesthesia.
- 3
Muscle release
The internal sphincter spasm is gently released with laser or a small controlled division.
- 4
Fissure care
The chronic edges and any sentinel tag are addressed at the same sitting.
- 5
Discharge
Home the same day with a healing and diet plan.
Recovery timeline
Same day
Immediate relief of the muscle spasm; home within hours.
1–2 days
Return to work; markedly less pain than before.
1 week
Comfortable bowel movements as healing progresses.
3–4 weeks
Complete healing with a high-fibre routine to prevent recurrence.
Risks & considerations
- Temporary minor bleeding or discomfort
- Very small risk of transient difficulty controlling wind, which typically settles
- Recurrence if constipation is not corrected
- Rare infection or delayed healing
Cost in Hyderabad
| Procedure | Indicative range |
|---|---|
| Laser fissure surgery (sphincterotomy) | ₹35,000 – ₹70,000 |
| Botox injection for fissure | ₹20,000 – ₹40,000 |
| Lateral internal sphincterotomy | ₹30,000 – ₹60,000 |
| Medical management (consultation & medicines)For acute fissures | ₹1,000 – ₹5,000 |
These are indicative ranges for Hyderabad and vary with the grade or complexity of the condition, the technique chosen, implants used, room category and insurance. They are not a quotation. Please contact the clinic for a personalised estimate after consultation.
Why choose Dr. Satish Reddy
Frequently asked questions
Yes — most acute fissures heal within a few weeks with a high-fibre diet, stool softeners, sitz baths and healing ointments. Surgery is considered only for chronic fissures that do not respond to these measures.
The procedure itself is done under anaesthesia, and laser treatment is minimally invasive. Most people notice that the severe fissure pain eases almost immediately once the muscle spasm is released.
Dr. Reddy uses sphincter-preserving, calibrated techniques specifically to protect continence. Any change in control is usually minor and temporary.
Keep stools soft and regular with a high-fibre diet, plenty of water and by avoiding prolonged straining. These habits are the single best way to prevent recurrence.
Medically reviewed by Dr. Y. Satish Reddy
MS, PDF (Surgical Gastroenterology) · Updated 1 September 2026