What is the first-line treatment for most anal fissures?

Warm sitz baths are the first-line treatment for most anal fissures because they help to alleviate pain and promote healing. The warm water soothes the area, increases blood flow, and can provide overall comfort while reducing muscle spasm in the anal sphincter, which is often associated with anal fissures. This simple and non-invasive remedy encourages relaxation and can assist with faster recovery without the need for more aggressive treatments.

Other treatment options, while potentially useful in certain situations, do not typically serve as the initial approach. Topical steroids may help to reduce inflammation but are not routinely used for the primary treatment of anal fissures. Surgical intervention is generally reserved for chronic fissures or cases that do not respond to conservative management, thus not making it the first-line treatment. Antibiotics are indicated only if there is an associated infection, which is not commonly the case with typical anal fissures. Therefore, warm sitz baths provide an effective and supportive means of treatment at the onset before exploring other options.