Anal Fissure Treatment Market - Global Industry Size, Share, Trends, Opportunity, and Forecast, Segmented By Treatment Type (Laxatives, Topical Nitrates, Calcium Channel Blockers, Stool Softeners, Surgery, Others), By Route of Administration (Oral, Topical, Others), By Distribution Channel (Hospital Pharmacies, Retail Pharmacies, Online Pharmacies), By Region and Competition, 2021-2031F

Forecast Period	2027-2031
Market Size (2025)	USD 2.03 Billion
CAGR (2026-2031)	6.91%
Fastest Growing Segment	Calcium Channel Blockers
Largest Market	North America
Market Size (2031)	USD 3.03 Billion

Market Overview

The Global Anal Fissure Treatment Market will grow from USD 2.03 Billion in 2025 to USD 3.03 Billion by 2031 at a 6.91% CAGR. The Global Anal Fissure Treatment Market comprises pharmacological agents and surgical interventions designed to heal anoderm tears. Key offerings include topical calcium channel blockers, nitrates, and sphincterotomy procedures. Growth is primarily driven by the rising incidence of chronic constipation and sedentary lifestyles which place excessive strain on the anal canal. According to the World Gastroenterology Organisation, in 2024, functional constipation, a primary precursor to anal fissures, was identified as the most common functional gastrointestinal disorder globally with a prevalence rate of 11.7%.

However, the market faces a significant challenge regarding treatment safety profiles. Surgical interventions carry risks of fecal incontinence while pharmacological options frequently cause debilitating headaches. These adverse events induce hesitancy among patients and practitioners, often delaying medical intervention in favor of conservative lifestyle changes. Consequently, the difficulty in balancing high efficacy with minimal side effects remains a major obstacle impeding broader market expansion.

Key Market Drivers

The increasing prevalence of chronic constipation and gastrointestinal disorders significantly influences the Global Anal Fissure Treatment Market by creating a consistent patient pool requiring therapeutic intervention. Chronic straining and hard stools associated with these conditions cause mechanical trauma to the anoderm, directly precipitating fissure formation. According to MedCentral, January 2024, in the 'Chronic Idiopathic Constipation Prevalence and Burden in the US', a national survey utilizing Rome IV diagnostic criteria identified that 6% of adults suffer from Chronic Idiopathic Constipation. This baseline of functional disorders is further compounded by the burden of autoimmune conditions which complicate anorectal health. According to the Crohn's & Colitis Foundation, May 2024, in the 'Summer Impact Report 2024', over 10 million people worldwide live with inflammatory bowel disease, a demographic highly susceptible to developing complex, recurrent fissures that drive the demand for specialized treatment protocols.

Rising demand for novel topical drugs and non-surgical alternatives serves as the second critical driver, reshaping the market as patients and practitioners seek to minimize the risks of incontinence associated with traditional sphincterotomy. Pharmaceutical advancements are now focusing on delivering high efficacy with improved safety profiles, encouraging higher patient compliance and early intervention. This shift is evident in recent commercial developments for topical vasodilators. According to Kalkine Media, December 2024, in the 'Acrux Secures Fourth FDA Approval for Nitroglycerin Ointment', Acrux Ltd received FDA approval for a generic Nitroglycerin Ointment 0.4%, entering a targeted therapeutic segment with annual sales surpassing US$23 million. Such regulatory milestones validate the industry's strategic pivot toward conservative, non-invasive pharmacological solutions that bridge the gap between lifestyle management and surgical necessity.

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Key Market Challenges

The major challenge obstructing the growth of the Global Anal Fissure Treatment Market is the unfavorable safety profile associated with current high-efficacy interventions. The market struggles to expand because both patients and practitioners frequently delay or avoid medical and surgical options due to the high probability of adverse events. This risk aversion encourages a prolonged reliance on conservative, non-revenue-generating lifestyle management, thereby directly reducing the volume of pharmacological prescriptions and surgical procedures performed annually.

The apprehension is particularly acute regarding surgical solutions, which are often viewed as a last resort due to the potential for permanent functional impairment. According to the European Society of Coloproctology, in 2024, the postoperative fecal incontinence rate associated with lateral internal sphincterotomy was estimated to range between 3% and 15%. Such statistics substantiate patient fears regarding long-term quality of life, creating a substantial barrier to the adoption of invasive therapies. Consequently, the market faces stagnation as the apprehension surrounding these debilitating side effects outweighs the demand for rapid clinical resolution, limiting the uptake of available treatment modalities.

Key Market Trends

The rapid adoption of minimally invasive laser therapies is transforming the surgical landscape by offering a sphincter-sparing alternative to traditional lateral internal sphincterotomy. These procedures, often utilizing diode or CO2 lasers, effectively ablate fibrotic tissue and relax the internal anal sphincter without the extensive cutting that risks permanent incontinence, directly addressing the safety concerns that historically limited surgical uptake. This modality is gaining traction because it significantly reduces postoperative pain and accelerates recovery times compared to conventional scalpel-based techniques. According to the Journal of Lasers in Medical Sciences, October 2024, in the 'High-Intensity Laser Therapy - An Option for Managing the Pain in Anal Fissures', a study of 38 patients treated with high-power diode laser therapy demonstrated a significant reduction in mean visual analogue scale pain scores from 4.1 pre-operatively to 0.1 by the 60th postoperative day, with minor complications observed in only 7.9% of cases.

Concurrently, there is an increasing utilization of Botulinum Toxin injections combined with fissurectomy as a preferred bridge between failed conservative management and invasive surgery. This trend is driven by the therapy's ability to induce temporary sphincter paralysis, allowing the anoderm to heal while avoiding the permanent muscle division associated with high incontinence risks. This approach appeals to both practitioners and patients by balancing clinical efficacy with the preservation of long-term bowel function. According to the ANZ Journal of Surgery, September 2024, in the 'Effectiveness of combined botulinum toxin and fissurectomy on chronic anal fissures - a systematic review', an analysis of 978 patients revealed that this sphincter-sparing protocol achieved a pooled healing rate of 81% while maintaining a negligible transient incontinence rate of just 1%, positioning it as a highly safe viable alternative to standard surgical interventions.

Segmental Insights

The Calcium Channel Blockers segment is currently the fastest-growing category in the global anal fissure treatment market due to its superior side effect profile compared to traditional nitrate therapies. While nitrates frequently cause severe headaches that lead to poor patient adherence, calcium channel blockers offer comparable efficacy with significantly fewer adverse reactions. Clinical guidelines from the American Society of Colon and Rectal Surgeons support this shift, recommending agents like diltiazem for chronic fissures. This medical consensus drives market expansion as healthcare providers prioritize treatments that ensure consistent patient compliance and effective symptom management without surgical intervention.

Regional Insights

North America maintains a leading position in the global anal fissure treatment market, driven by the high prevalence of gastrointestinal disorders such as inflammatory bowel disease and chronic constipation. The region benefits from a developed healthcare infrastructure and high patient awareness regarding colorectal health. Furthermore, the presence of major pharmaceutical companies ensures the consistent availability of effective treatments. The United States Food and Drug Administration supports this growth through the regulatory approval of specific pharmaceutical interventions. These factors, alongside favorable medical reimbursement structures, secure North America’s dominance in the global landscape.

Recent Developments

• In October 2025, the digital health startup Bummed launched a comprehensive telehealth platform specifically designed for anorectal care, addressing conditions such as anal fissures, hemorrhoids, and constipation. The new service was introduced to provide patients with direct access to specialized clinicians and custom-compounded prescription treatments, including creams for fissure relief, delivered to their homes. The company emphasized its focus on destigmatizing anorectal health issues and improving access to care for underserved patient populations, particularly pregnant women who frequently experience these conditions.
• In December 2024, Acrux Limited announced that it had received approval from the U.S. Food and Drug Administration (FDA) for its generic Nitroglycerin Ointment, 0.4%. The company confirmed that this product, which is indicated for the management of pain associated with chronic anal fissures, would be commercialized in the United States through its licensee, TruPharma. This regulatory milestone marked the company's sixth approval for a topical generic product and allowed it to enter a market segment with annual sales exceeding USD 23 million.
• In October 2024, new clinical research findings were published in the Polish Journal of Surgery demonstrating the efficacy of a medical device developed by Hexanova Sp. z o.o. for the treatment of anal fissures. The study evaluated the company's Procto-Zac MemeThol Barrier Spray, a TRPM8 receptor agonist, in 120 patients and reported that the non-invasive therapy significantly relieved symptoms and promoted healing without the side effects often associated with traditional pharmacological treatments. The researchers concluded that the spray offered a promising conservative treatment alternative for acute and chronic fissures.
• In February 2024, Cosette Pharmaceuticals, Inc. announced the U.S. Food and Drug Administration (FDA) approval and subsequent commercial launch of the first generic version of Rectiv (nitroglycerin) ointment, 0.4%. This product, indicated for the treatment of moderate to severe pain associated with chronic anal fissures, was granted 180 days of Competitive Generic Therapy (CGT) exclusivity. The company highlighted that this approval represented a significant milestone in its strategy to expand its portfolio of topical generics and provide affordable treatment options for patients suffering from this painful anorectal condition.

Key Market Players

• AbbVie Inc.
• Novartis AG
• Teva Pharmaceutical Industries Ltd.
• RDD Pharma Ltd.
• Cipla Limited
• Sanofi SA
• Boehringer Ingelheim International GmbH
• Troikaa Pharmaceuticals Ltd.
• Kyowa Kirin Co., Ltd.
• Lupin Limited

By Treatment Type	By Route of Administration	By Distribution Channel	By Region
Laxatives Topical Nitrates Calcium Channel Blockers Stool Softeners Surgery Others	Oral Topical Others	Hospital Pharmacies Retail Pharmacies Online Pharmacies	North America Europe Asia Pacific South America Middle East & Africa

Report Scope:

In this report, the Global Anal Fissure Treatment Market has been segmented into the following categories, in addition to the industry trends which have also been detailed below:

• Anal Fissure Treatment Market, By Treatment Type:

• Laxatives
• Topical Nitrates
• Calcium Channel Blockers
• Stool Softeners
• Surgery
• Others

• Anal Fissure Treatment Market, By Route of Administration:

• Oral
• Topical
• Others

• Anal Fissure Treatment Market, By Distribution Channel:

• Hospital Pharmacies
• Retail Pharmacies
• Online Pharmacies

• Anal Fissure Treatment Market, By Region:

• North America
• United States
• Canada
• Mexico
• Europe
• France
• United Kingdom
• Italy
• Germany
• Spain
• Asia Pacific
• China
• India
• Japan
• Australia
• South Korea
• South America
• Brazil
• Argentina
• Colombia
• Middle East & Africa
• South Africa
• Saudi Arabia
• UAE