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Chronic anal fissure. On laxative, applying cream. Still having pain after passing stools. Suggestions?

I am suffering from chronic anal fissure . During last week of September I had hard stool which caused anal fissure. It got healed after I did sitz bath for a week. But last week of November I again had hard stool which again caused anal fissure. I did sitz bath again but this time my condition kept worsening. Now I can feel a small ball of hard tissue on the verge of my anus . For the treatment I take lactulose and milk of magnesia for last one month. I also apply Diltiaz 2% gel daily before and after passing stool. I also apply it before I go to bed in the night. For last 10 days my condition was improving continuously but today I had pain for almost 12 hours after passing stool in the morning. Do you think I should go for surgery? How long I can take laxative like milk of magnesia?
Asked On : Wed, 16 Jan 2013
Answers:  1 Views:  138
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Gastroenterologist 's  Response
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

Yes you have signs and symptoms of chronic fissure in ano. You doing the right thing by taking laxatives and applying diltiaz anddoing sitz bath.
But in spite of doing all these, if you still get symptoms, then it is time to go for surgery.
In fissure in ano, the anal sphincter goes in for spasm. In the surgery done, the sphincter is cut which will provide relief.
so if you think medications and sitz bath are not providing relief, then go for surgery.
I hope that answers your question.
Dr.Ratnakar Kini
Answered: Thu, 5 Dec 2013
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