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Treatment[ edit ] Non-surgical treatments are recommended initially for acute and chronic anal fissures. A common side effect drawback of nitroglycerine ointment is headache, caused by systemic absorption of the drug, which limits patient acceptability. A combined surgical and pharmacological treatment, administered by colorectal surgeons, is direct injection of botulinum toxin Botox into Free Fresno anal sex anal sphincter to Birmingham states list it.

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