040 68334455
WhatsApp
Patient Portal
Home Care
Anal fissure: Causes, Symptoms, Diagnosis and Treatment
Written by Medicover Team and Medically Reviewed by Dr Chukka Sanyasi Naidu , General Surgeons
Though not life-threatening, an untreated anal fissure can be debilitating due to recurring pain and discomfort. With early care, most people recover fully without advanced treatment.
Be patient, consistent with hygiene, and monitor any changes. Chronic cases require a bit more diligence and possibly a doctor's intervention.
What is Anal Fissure?
An anal fissure is a small cut or tear in the lining of the anus, typically caused by trauma during bowel movements. It's often triggered by straining, constipation, or passing hard stools. While painful, especially during or after defecation, most fissures are not serious and respond well to simple home care if treated early.
Anal fissures can affect people of all ages. Fortunately, most anal fissures can be easily treated through simple interventions such as increasing fiber intake or warm-water baths. However, in some cases, medication or surgery may be necessary to treat anal fissures.
What Causes Anal Fissures?
Anal fissures are usually caused by trauma to the anal lining, such as passing hard stools or straining during bowel movements. Other factors, like chronic diarrhea or inflammation, can also contribute to their development.
Here are the most common causes
- Passing hard or large stools: This is the most common cause. It can stretch the skin and cause a tear.
- Constipation: Straining during bowel movements puts extra pressure on the anal area.
- Chronic diarrhea: Frequent loose stools can irritate the skin and cause a fissure.
- Tight anal muscles: If the muscles around the anus are too tight, they can reduce blood flow and make healing slower.
- Childbirth: Pushing during delivery can lead to fissures in some women.
- Anal trauma: Inserting objects or rough wiping can damage the area.
- Inflammatory conditions: Diseases like Crohn's disease or ulcerative colitis can make the skin more likely to tear.
Get a second opinion from trusted experts and makeconfident, informed decisions.
Get Second OpinionWhat are the Anal Fissure Symptoms and Warning Signs?
Anal fissures often cause pain and discomfort during bowel movements. Recognizing the common symptoms and warning signs early can help you seek timely treatment and avoid complications.
- Pain during defecation: Anal fissures often cause sharp pain during bowel movements.
- Pain after bowel movements: This discomfort can persist for several hours.
- Visible skin crack: A noticeable tear around the anus, sometimes with a visible crack.
- Presence of bright red blood: Blood may appear on toilet paper or Bleeding While Passing Stool
What Leads to Anal Fissures?
The main culprit is physical strain, like pushing too hard during bowel movements.
Other contributing factors include:
- Chronic constipation or diarrhea
- Low-fiber diet
- Dehydration
- Anal sex or trauma
- Inflammatory bowel diseases like Crohn's
How is Anal Fissures Diagnosed?
The doctor will most likely ask about the medical history and perform a physical exam, which will include a gentle digital examination of the anal region. The tear is frequently noticeable. This exam is usually all that is required to identify an anal fissure.
- Anoscopy: A tool inserted into the anus to examine the area.
- Flexible sigmoidoscopy: A Flexible sigmoidoscopy procedure to examine the sigmoid colon with a camera.
- Colonoscopy: A deeper examination of the colon, particularly for those over 45 or with symptoms like abdominal pain or diarrhea.
What are the Treatment Options for Anal Fissure?
Anal fissures are often self-limiting and can heal with conservative management. However, treatment varies based on whether the fissure is acute (short-term) or chronic (lasting over 6 to 8 weeks):
Conservative (Home-based) Treatments
- Sitz baths: Soaking in the warm water for 10 to 20 minutes, especially after bowel movements, can relax the sphincter and promote healing.
- Topical ointments: Lidocaine for pain relief or hydrocortisone for inflammation.
- Fiber supplements: A high-fiber diet helps soften stools and prevents straining. Psyllium husk or methylcellulose can soften stools.
- Increased water intake: Hydration supports smoother bowel movements.
Medications (for persistent cases)
- Nitroglycerin ointment: Improves blood flow and reduces muscle spasm.
- Calcium channel blockers: Such as diltiazem or nifedipine, are used to relax sphincter tone.
- Botox injections: Temporarily paralyze anal muscles, promoting healing.
Surgical Treatment
- Lateral internal sphincterotomy: A small incision in the anal sphincter muscle to relieve pressure and facilitate healing. It's usually considered when other methods fail.
When Should You See a Doctor for Anal Fissures?
You should see a doctor if you have pain during bowel movements, bright red blood on toilet paper, or a small tear around the anus that doesn't heal within a few days. Also, seek care if the pain is severe, keeps coming back, or makes it hard to pass stool.
If you notice bleeding with no clear cause, swelling, or discharge, don't wait to get it checked. These may point to an infection or other problems. Early treatment can relieve pain, prevent infection, and help the tear heal faster.
Your health is everything - prioritize your well-being today.
Consult Anal Fissure Doctors Today
What is the Recovery Process after Anal Fissure Treatment?
Recovery from anal fissure treatment depends on the severity and method used. With proper care, most people heal within a few weeks. Following your doctor's advice, maintaining soft stools, and keeping the area clean can speed up healing and prevent recurrence.
- Acute fissures usually heal within 1 to 2 weeks with basic care.
- Chronic fissures may take 6 to 12 weeks with medications.
- After surgery, most people resume normal activities within a week, with complete healing over 4 to 6 weeks.
- Post-treatment care includes maintaining soft stools, avoiding straining, and practising good hygiene.
What Precautions Can Help Prevent Anal Fissures?
Taking certain precautions can help reduce the risk of developing anal fissures. These include habits that promote gentle and regular bowel movements to protect the delicate skin around the anus.
Lifestyle Modifications
- Stay hydrated: Drink at least eight glasses of water daily.
- High-fiber diet: Include vegetables, fruits, legumes, and whole grains.
- Avoid constipation: Don't delay bowel movements and avoid straining.
- Regular exercise: Keeps bowel function active.
- Proper toilet habits: Use a footstool to simulate squatting posture.
If you have conditions like IBD or chronic constipation, regular check-ups with a gastroenterologist can help prevent complications such as fissures or hemorrhoids.
Risk Factors for Anal Fissures
The following factors may increase the chances of having an anal fissure:
- Constipation: Constipation is increased by straining during bowel movements and passing hard stools.
- Childbirth: Women are more likely to develop anal fissures after giving birth.
- Crohn's disease: Chronic intestinal inflammation is caused by this inflammatory bowel disease. This could make the anal canal lining more prone to tears.
- Age: Anal fissures can develop at any age but are more frequent in infants and middle-aged adults.
What are the Complications of Untreated Anal Fissure?
If left untreated, an anal fissure can become chronic and lead to ongoing pain, bleeding, and discomfort. It may also cause muscle spasms, infection, or the development of a sentinel pile or anal fistula. Timely treatment can help prevent these complications.
If left untreated, an anal fissure may progress to
- Chronic fissure: Deepens and becomes harder to heal.
- Anal stenosis: Narrowing of the anal canal, making defecation difficult.
- Fistula formation: An abnormal tract may develop between the anus and skin.
- Persistent pain and spasms: Due to ongoing muscle contraction and irritation.
Chronic discomfort can also lead to fear of defecation, worsening constipation and creating a vicious cycle.
What are the Anal Fissures Dos and Don'ts?
Following the right habits can help relieve symptoms of anal fissures and prevent them from coming back. Here are some simple do's and don'ts to keep in mind:
| Do's | Don'ts |
|---|---|
|
Drink plenty of water throughout the day |
Don't ignore the pain or delay treatment |
|
Eat high-fiber foods (vegetables, fruits, whole grains) |
Don't strain or sit too long on the toilet |
|
Take warm sitz baths to relax the area |
Avoid rough toilet paper; use wet wipes or rinse gently |
|
Use creams or ointments (e.g., lidocaine) |
Avoid spicy, greasy, or hard foods that irritate the gut |
|
Use a footstool while using the toilet for better posture |
Don't use harsh soaps or creams without medical advice" |
Our Experience in Treating Anal Fissures
At Medicover Hospitals, we specialize in diagnosing and treating anorectal disorders like anal fissures with a patient-first approach. Our experienced gastroenterologists and colorectal surgeons use evidence-based techniques, from non-invasive therapies to advanced surgical options.
With dedicated post-treatment support and lifestyle guidance, we aim to restore your comfort and prevent recurrence. Trust Medicover for compassionate, expert care at every step.
