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First-line therapy often includes the conservative measures plus a topical drug. The preparations used in clinical practice contain glyceryl trinitrate or a calcium channel blocker. A recent cochrane review reported that topical glyceryl trinitrate is better than placebo in healing anal fissures (healing rates 49.).   this type of anal fissure ointment is commonly available only with a prescription as well. The third type of topical medication commonly prescribed for patients with anal fissures includes a topical anesthetic.   anal fissure ointment is a common treatment for rectal tears also known as anal fissures. Nitroglycerin ointment is a popular variety, but ointments containing zinc oxide or hydrocortisone also can be used. When seeking to relieve symptoms associated with anal fissures, non-surgical treatments are recommended initially for acute and chronic anal fissures. These treatment options usually include topical nitroglycerin or calcium channel blockers. Through topical ointments, the sphincter muscle can relax in order to stimulate the healing process. Topical calcium channel blockers are thought to be about as effective as gtn ointment for treating anal fissures, and may be recommended if other medicines havent helped. These may include a medicated cream (to help heal the fissure), a topical muscle relaxant (to relax the anal muscles), an anesthetic ointment (to reduce pain, if pain interferes with having a bowel movement), or nitroglycerin or calcium channel blocker ointments (to relax the anal muscles and increase blood.). Topical 2 per cent diltiazem ointment used as an agent for chemical sphincterotomy for chronic anal fissure offers significant healing rates but does not have a significant side-effect profile, which may aid compliance to treatment. Usually, treatment focuses on establishing and maintaining a routine for proper anal hygiene. If a secondary or underlying cause is found, the treatment will depend on the specific condition. Topical medications topical steroids, such as creams or ointments containing 1 hydrocortisone, may help to relieve itching and irritation.   topical anal preparations are readily available, easy to apply and often work well. There are pitfalls for the general practitioner to be aware of, as not all symptoms are due to my haemorrhoids, doctor. Perianal symptoms are limited to pruritus, bleeding, pain, discharge or a lump.

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