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In such cases, care must be taken not to include a piece of the internal sphincter with the excision. A doctor's observation on anal fissure treatment The author has found that when there are enlarged internal hemorrhoids in addition to a fissure, that healing of the fissure is improved if the hemorrhoids are treated with sclerotherapy that shrinks them. Causes and Treatments Surgical treatment for anal fissures The Standard Task Force of the American Society of Colon and Rectal Surgeons has recommended a surgical procedure called partial lateral internal sphincterotomy as the technique of choice for the treatment of anal fissures. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. The dose of nitroglycerin often is limited by side effects.


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