Botulinum toxin for chronic anal fissure

Lancet. 1994 Oct 22;344(8930):1127-8. doi: 10.1016/s0140-6736(94)90633-5.


Botulinum toxin can chemically denervate striated muscle. Botulinum toxin A (15 U) was used to treat ten patients with chronic anal fissure by injection in the internal sphincter. In seven patients, the lesion healed at 2 months after treatment; one relapsed at 3 months. In one patient the lesion healed at 1 month, but partly relapsed a month later. Mild faecal incontinence lasting for 1 day was observed in one patient. We propose that botulinum toxin injections in the internal anal sphincter be considered an alternative approach to surgical therapy of anal fissure.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal / physiopathology
  • Botulinum Toxins / administration & dosage
  • Botulinum Toxins / adverse effects
  • Botulinum Toxins / therapeutic use*
  • Chronic Disease
  • Female
  • Fissure in Ano / physiopathology
  • Fissure in Ano / therapy*
  • Follow-Up Studies
  • Humans
  • Injections, Intramuscular
  • Male
  • Manometry
  • Middle Aged
  • Pressure


  • Botulinum Toxins