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Acute fissures should be treated conservatively with dietary modification. Chronic fissures do not respond to conservative treatment. The current recommended surgical treatment for chronic fissure is lateral internal sphincterotomy. However, there is a disturbance of continence in a sizeable proportion of those undergoing this procedure. As yet there is no proven non-surgical treatment for chronic fissure. Although local injection of botulinum toxin and the topical application of nitrates show early promise, further controlled trials are needed.<\/jats:p>","DOI":"10.1002\/bjs.1800831006","type":"journal-article","created":{"date-parts":[[2007,3,1]],"date-time":"2007-03-01T13:02:08Z","timestamp":1172754128000},"page":"1335-1344","source":"Crossref","is-referenced-by-count":222,"title":["Aetiology and treatment of anal fissure"],"prefix":"10.1093","volume":"83","author":[{"given":"J N","family":"Lund","sequence":"first","affiliation":[{"name":"Department of Surgery, University Hospital , Nottingham NG7 2UH,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J H","family":"Scholefield","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital , Nottingham NG7 2UH,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1996,10,1]]},"reference":[{"key":"2024092815564741600_bib1","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1136\/bmj.2.5318.1500","article-title":"Results of internal sphincterotomy for anal fissure","volume":"2","author":"Bennett","year":"1962","journal-title":"BMJ"},{"key":"2024092815564741600_bib2","volume-title":"Surgery of the Anus, Rectum and Colon","author":"Goligher","year":"1984","edition":"5th"},{"key":"2024092815564741600_bib3","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1002\/bjs.1800750120","article-title":"Anal fissure in Crohn's disease","volume":"75","author":"Sweeney","year":"1988","journal-title":"Br J Surg"},{"key":"2024092815564741600_bib4","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/BF02048328","article-title":"Anal fissure in Crohn's disease: a plea for aggressive management","volume":"38","author":"Fleshner","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"2024092815564741600_bib5","volume-title":"Surgery of the Anus, Rectum and Colon","author":"Keighley","year":"1993"},{"key":"2024092815564741600_bib6","volume-title":"International Symposium of Gastrointestinal Motility","author":"Von Trappen","year":"1975"},{"key":"2024092815564741600_bib7","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1136\/gut.17.4.306","article-title":"Influence of autonomic nerves on the internal anal sphincter in man","volume":"17","author":"Frenckner","year":"1976","journal-title":"Gut"},{"key":"2024092815564741600_bib8","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/0016-5085(79)90009-X","article-title":"Responses of isolated human internal anal sphincter to drugs and electrical field stimulation","volume":"77","author":"Burleigh","year":"1979","journal-title":"Gastroenterology"},{"key":"2024092815564741600_bib9","first-page":"155","article-title":"Some pharmacological responses of isolated internal sphincter strips from chronically constipated children","volume":"71","author":"Paskins","year":"1982","journal-title":"Scand J Gastroenterol Suppl"},{"key":"2024092815564741600_bib10","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1111\/j.2042-7158.1983.tb02927.x","article-title":"Non-cholinergic, non-adrenergic inhibitory neurons in human internal anal sphincter muscle","volume":"35","author":"Burleigh","year":"1983","journal-title":"J Pharm Pharmacol"},{"key":"2024092815564741600_bib11","first-page":"G107","article-title":"Role of nitric oxide as a mediator of internal anal sphincter relaxation","volume":"262","author":"Rattan","year":"1992","journal-title":"Am J Physiol"},{"key":"2024092815564741600_bib12","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/0016-5085(92)90084-C","article-title":"Involvement of the L-arginine-nitric oxide pathway in internal anal sphincter relaxation","volume":"102","author":"Tottrup","year":"1992","journal-title":"Gastroenterology"},{"key":"2024092815564741600_bib13","first-page":"G7","article-title":"Release of nitric oxide by activation of nonadrenergic noncholinergic neurons of internal anal sphincter","volume":"264","author":"Chakder","year":"1993","journal-title":"Am J Physiol"},{"key":"2024092815564741600_bib14","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1007\/BF02053596","article-title":"Distribution of nitric oxide synthase containing neurons in the rectal myenteric plexus and anal canal. 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