Anal Fissures: What You Need To Know
An anal fissure is a small tear or crack in the lining of the anal canal. It occurs more commonly in children, young people, and pregnant women. Although most fissures will heal with at-home care, some patients may require treatment from a healthcare provider.
Symptoms
The most common symptoms of an anal fissure are pain and bleeding, especially during or after bowel movements. If you have a fissure, you may notice:
- Pain during or after passing stool
- Blood on the stool or toilet paper (it will be bright red, not dark or black)
- A crack in the skin, a small lump or skin tag around the anus
- Anal irritation or itching
Causes
Anal fissures are caused by damage to the anal lining (inside the anus) as a result of stretching or straining from conditions like constipation. The most common causes include:
- Chronic constipation (especially when it causes straining)
- Chronic diarrhea (which can cause the anal lining to become dry)
- Pregnancy and childbirth
- Anal intercourse
Less often, they may be caused by other conditions including inflammatory bowel disease, sexually transmitted diseases, surgical procedures, tuberculosis or anal cancer.
Treatment & Prevention
Most anal fissures will heal within several days or up to a few weeks without treatment, although there are some self-care measures you can take to help ensure they heal on their own. They include:
- Avoid straining during bowel movements.
- Preventing constipation or diarrhea. Try increasing your fiber intake and use stool softeners or anti-diarrheal medication temporarily if needed.
- Stay properly hydrated.
- Keep the anal area clean. Wash with water after a bowel movement or try wipes. Don’t over wipe with dry toilet paper and be gentle when wiping.
If your fissure has not healed within several weeks, or if your condition is too painful, you should make an appointment with your doctor. They will examine you and provide treatment depending on your individual care needs.
This can include medication for pain relief and/or to help with blood flow and relaxing the anal muscles. If these don’t work, Botox® injections may offer relief. For fissures that won’t heal with medication, a minor procedure (an internal sphincterotomy) may be performed to permanently resolve sphincter tension that is causing the fissures.
Seeking treatment for anal fissures that don’t go away by themselves is important. Possible complications include anal fistula, fecal impaction, and narrowing of the anal canal (anal stenosis).
You can also help prevent them from returning – or occurring in the first place – by keeping your bowels regular with a healthy lifestyle that prevents constipation and diarrhea.
It is important to note that pain or blood in the stool is not always caused by anal fissures. It can also be caused by hemorrhoids and other more serious conditions. You should see your healthcare provider if you experience these symptoms to get a proper diagnosis.
The team at GastroIntestinal Specialists, A.M.C., treats multiple conditions and diseases of the GI tract. Our Board-Certified physicians have over 150 years of combined experience in providing quality care you can trust. To schedule an appointment, call (318) 631-9121 or visit gis.md/appointment-request/.