Anal fissures

Abstract

Anal fissures and haemorrhoids are common anorectal complaints seen in general practice. Both conditions share simiJar signs anti symptoms and so making an assessment of the patient's condition in the pharmacy can be difficult. Evidence suggests that treating acute anal fissures early may prevent progression to a chronic state. Pharmacists are well placed to provide an early intervention to patients with acute anal Fissure. Conservative care, involving fibre supplementation and increased Fluid intake, is indicated as first line in the management the majority of acute anal fissures as well as in the ongoing management of chronic anal fissure. Where conservative care is not adequate, topical gylceryl trinitrate may be recommended to relieve pain associated with chronic anal fissure and improve healing. This treatment option offers a non-invasive and cost-effective alternative to surgical options and botox injection. Topical anaesthetics are preferred ewer topical corticosteroids for the relief of associated itch. Patients should be counselled on the potential of headache during topical GTK therapy, as well as how to manage it effectively. As this adverse effect is dose dependent, the recommended dosing directions should be emphasised.