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This study will be integrated within an existing, real-world treatment infrastructure containing well-established treatment outcomes collected up to 1 year post discharge, enhancing the applicability of this study to broad treatment contexts

Diltiazem 2%/Lidocaine 3% Ointment Used for anal fissures (tear near anus) Helps heal the fissure (wound) and relieve pain Application: dispensed with finger cots to make application less yucky Onset: pain relief should be quick

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PT-141 (Bremelanotide) activates melanocortin receptors MC1RMC5R within the central nervous system