Anal fissures are small tears found in the mucosa, which is the thin, moist tissue lining the anus. While anal fissures are common among infants, they can happen at any age, and they are the result of passing hard and/or large stools. They can also be caused by childbirth, anal intercourse, chronic diarrhea, or straining to pass a bowel movement as a result of constipation. Inflammatory bowel conditions like Crohn’s disease can also make a person more susceptible to anal fissures.

Applicable Procedures

Colonoscopy
Flexible Sigmoidoscopy

Are anal fissures serious?

Anal fissures typically get better on their own with relatively simple measures, like increasing the amount of fiber in your diet or taking a stiz bath. Some people may need medications to manage anal fissures, and less commonly, surgery may be necessary. If an anal fissure does not heal within 8 weeks, it is considered chronic and may require more formal treatment, especially if the tear extends to the internal anal sphincter, which is the muscle that holds the anus closed.

Which treatments or medications are typically used if treatment is needed for anal fissures?

A doctor may recommend nitroglycerin applied externally to relax the anal sphincter and increase blood floor in order to heal the anal fissure. Blood pressure medications and Botox injections can also be used to relax the anal sphincter as treatment for anal fissures. Doctors may recommend the use of topical agents like lidocaine to relieve pain. If your anal fissure is severe or does not respond to less invasive treaments, a doctor may perform a surgery called a lateral internal sphincterotomy, which involves removing a small part of the anal sphincter muscle.

Are there ways to prevent anal fissures?

Having one anal fissure increases your risk of experiencing another in the future, but there are steps you can take to prevent recurring fissures. Taking a fiber supplement and increasing the amount of high-fiber foods, such as fruits, vegetables, whole grains, and beans, in your diet can soften your stool and reduce your risk of anal fissures. The ultimate goal is to eat 25-30 grams of fiber per day, but you may need to gradually increase fiber in your diet to prevent bloating. Drinking enough water, which prevents constipation, and avoiding straining during bowel movements, which can cause a tear, are also preventive measures for anal fissures.

Common Symptoms

• “I suddenly began to experience pain during bowel movements, and I noticed I was bleeding afterward.”
• “After wiping, I saw fresh, bright red blood on the toilet paper, and I was in pain for several hours.”
• “I felt a small bump near my anus, as well as a small crack in the skin around that area.”