Normally it will take approximately 6 weeks for the fissure to heal, although the pain will generally improve within the first 1-2 weeks. In some situations, the fissure becomes chronic and requires surgical intervention. This is generally secondary to anal stenosis which can be evaluated on digital examination. In patients who have anal stenosis and intermittent fissure disease or a chronic fissure, a lateral internal sphincterotomy is curative. The third condition is that of anorectal suppuration .
Perianal abscesses are common conditions.
The abscess starts as an infection in the anal gland located in the intramuscular plane. The intramuscular abscess is the initial lesion and this frequently ruptures through the sphincter mechanism and presents as a tender mass on the perianal skin. The treatment for this condition is that of incision and drainage. Most of the time, this can be done in the office under local anesthesia. This will require surgical intervention to correct.