Management of Anal Fissures

Acute fissures: defined as symptoms present for fewer than 8 weeks, will appear as a longitudinal tear.

Chronic fissures: (of a longer duration), will manifest one or more stigmata of chronicity, including a hypertrophied anal papilla at the proximal aspect of the fissure, a sentinel tag at the distal aspect of the fissure, and exposed internal anal sphincter muscle within the base of the fissure.