Anal fissure is a laceration in the soft layer of the anal canal which is caused by overstraining during bowel movement. The tears can also be caused by explosive diarrhea, excessive laxative use, anal sex, and difficult childbirth.
The condition causes severe pain during and after bowel movement, radiating to the lower back, buttocks, and thighs. Once causative factors are eliminated (specifically constipation), fissures can heal spontaneously in about 8 weeks.
Fissures are highly treatable, even without surgery. Pain relief, management of constipation, and hastening wound healing are the targets of fissure treatment. The best over-the-counter medications for anal fissures hasten the time of recovery from this painful disorder.
Managing Constipation
Treatment of anal fissures focuses on the prevention of the immediate cause which is constipation. Bowel movement can be very traumatic for patients suffering from this disease, thus stool must be made softer to prevent straining and damaging the lacerated wall of the anus. The following are the best over-the-counter medications for anal fissures:
Powdered psyllium – this is a fiber supplement available at any drug store or health food stores. It attracts water to the stool, making it soft and easier to expel.
It should be taken with at least 8 ounces of liquid (most preferably water). Total fluid intake should be increased when taking any fiber supplement as they form a mass, causing obstruction to the bowels and aggravating problematic bowel movement.
Common side effects of psyllium include gas or stomach cramping. Severe adverse and allergic reactions are rare. However, call emergency in the event that you experience choking (chest pain, difficulty swallowing), difficulty breathing, and swelling of face and throat.
Docusate sodium (Colace, Dialose, etc.) – stool softeners used as adjunct therapy to fiber supplementation. It works the same way as psyllium – making stool bulkier and easier to expel.
It is usually taken at night with a glass of water or juice. It comes in tablet, liquid, and drop forms. Medication cups or other similar devices should be used to ensure correct dosage. Liquid forms are mixed with fruit juice to mask bitter taste which causes throat irritation.
Side effects of docusate include stomach pain, cramping and diarrhea. Stopping the medication or decreasing the dose can prevent the incidence of diarrhea.
Managing Pain
Ibuprofen – is an OTC drug which reduces pain and swelling. Oral use (200mg, 400mg tablets) are recommended for fissures. It is contraindicated to people with reported NSAIDs allergy, bleeding disorders, and to pregnant and lactating women. Common side effects include mild gastric distress and vision problems. One should avoid driving and operating heavy machinery when using ibuprofen.
Witch Hazel Extract – functions as an astringent which helps stop bleeding associated with anal tears. It gives a soothing sensation upon application providing pain relief. It also helps in wound healing and prevents infection.
Witch hazel cream is one of the best over the counter medications for anal fissures and other anal disorders. It is applied to the affected area six times a day, specifically after every bowel movement. Reported side effects include minor skin irritation.
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