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When the point of the blade is at the dentate line the internal sphincter is divided by cutting medial to lateral. Learn how to get rid of hemorrhoids, the difference between internal hemorrhoids and external hemorrhoids, what causes hemorrhoids, how long hemorrhoids last, and hemorrhoids treatment. WHAT CAN BE DONE IF THE FISSURE DOES NOT HEAL? Pediatric Surgery Seventh Edition , What causes anal fissures? Anal fissure is a common problem. The inciting factor, whether constipation or diarrhea, should be corrected.
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Anal Fistulas and Fissures

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Managing anal fissures

We prefer to manage these patients with sitz baths and an osmotic stool softener such as polyethylene glycol, although any form of stool softener is sufficient. I had a slight headache which I could live with, but this was far better than the agony of the fissure and this headache was pretty much gone after the first week. Most anal fissures are caused by stretching of the anal mucosa beyond its capability.
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