fissure in ano is break in anoderm,its acute when less than 6 weeks & chronic if lasts more than 6 week. every 5th person has to suffer in his life time,and its most painfull condition of anus,except in pregnant and during labour in females,most of cases cause is not known,most common symtoms are pain and bleeding /rectum. managements includes wide range of options 1.
conservative...hot sitz bath,laxatives,local lignocaine,oral and local vasodilator inj botulinum toxin 2. surgery...lateral subcutaneous internal sphinterotomy,anal dilation,cryo,cautry laser application and many more but for acute frist preferance for conservative, nitroglycerine is effective vasodilator as for coronary vesseles,nitroglycerine produced nitric oxide that dilate both veins and arteries ,its relax internal sphinter,improves blood supply so improves healing, is glyceryl trinitrate in .2 to .5% oinment frist…
