Chronic Anal Fissure in Female Patients Who Are Pregnant or Breastfeeding

This protocol addresses the management of a chronic anal fissure in a female patient who is currently pregnant or breastfeeding — a situation that requires careful consideration before initiating any nonsurgical treatment.

Clinical Situation

Prescription of nonsurgical treatments in female patients with a chronic anal fissure who are pregnant or breastfeeding may be considered with caution. The physiological state of pregnancy and lactation significantly influences the selection of safe treatment options.

Treatment Approach (partial)

A specific injectable intervention may be considered in this context — but only where treatment is essential or where no other options are available.

Complete regimen, eligibility criteria, and clinical guidance are available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/codi.167

Prescription of nonsurgical treatments in female patients with a chronic anal fissure and who are pregnant, or breast feeding may be considered with caution.

Theoretically, botulinum toxin is not systemically absorbed from the site of administration if injected correctly and should not cross the placenta.

The BNF advises avoiding unless treatment is essential, and the UK teratology information service suggests that it is an option where there are no other treatments available.

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