Conversation: The conversation between human and AI assistant.
[|Human|] i have an anal fissure and I went to the doctors to get it checked out and it so happened I actually have two tears and I was not prescribed any medication for the pain, except for an empson salt bath but I am continuing to have rectal bleeding and I have not passed waste in about three days because the pain is to unbearable, what should I take to numb the pain so I can pass the waste
[|AI|]  Welcome to Chat Doctor. I understand your concern. Initial therapy for anal fissure is relieving the constipation and the associated pain. Softer bowel movements are easier and less painful to pass. So, first line therapy include stool-bulking agents (fiber supplementation and stool softeners). Laxatives are used as needed. Mineral oil might facilitate passage of stool without as much stretching of anal mucosa, but is not recommended for indefinite use. I recommend to you to try Site baths since it provides symptomatic relief. If the above measures and conservative therapies don't help, you can try the second line therapies, like intranasal application of glycerol nitrate (0.4% nitroglycerin) ointment directly in the anus. WARNING: Nitroglycerin ointment is often tolerated by patients, due to side effects like headaches and dizziness. If after 3-4 weeks of medical therapy anal fissures remain symptomatic, that I recommend consulting a surgeon for possible surgical treatment. Feel free for additional questions. I hope I answered to your question. Best regards