About 9 out of 10 short-term fissures heal with home treatment-including using stool softeners or fiber supplements and taking regular sitz baths. And about 4 out of 10 long-term anal fissures will heal after home treatment is used.
But not all fissures will heal with just home treatment. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include nitroglycerin cream, high blood pressure medicines in pill or gel form, or injections of botulinum toxin (Botox).
If medicines don't stop your symptoms, you may need to consider surgery. The most commonly used surgery is lateral internal sphincterotomy. In this procedure, a doctor cuts into part of the internal sphincter to relax the spasm that is causing the fissure.