An anal fissure is a tear or open wound that develops in the lining of the rectum, near the anus.
Symptoms
The most common symptoms of anal fissures include:
- acute pain
- Bleeding – most people notice a small amount of bright red blood either on their stools or on the toilet paper
When to see a doctor
Visit a doctor if you think you have an anal fissure. Don’t let embarrassment stop you from seeking help. Anal fissures are a common issue that doctors are used to dealing with. Most fissures improve without treatment, but your doctor will want to rule out other conditions with similar symptoms, such as hemorrhoids. They can also provide advice on self-care measures and treatments that can relieve your symptoms and reduce the risk of recurring fissures.
Diagnosis
Your doctor will ask you about your symptoms and the type of pain you’ve experienced. They may also inquire about your bowel habits. If your doctor suspects that something more serious could be causing the fissure, they may refer you for further evaluation. This could include a more thorough examination, sometimes using an anesthetic to minimize pain. Occasionally, your doctor may measure the pressure of the anal sphincter for fissures that haven’t responded to simple treatments. The anal sphincter is the muscle ring that opens and closes the anus.
Causes of Anal Fissures
Anal fissures are most commonly caused by damage to the lining of the anus or anal canal, the last part of the colon.
Other possible causes of anal fissures include:
- Persistent diarrhea
- inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis
- pregnancy and childbirth
- occasionally, a sexually transmitted infection (STI), such as syphilis or herpes, which can infect and damage the anal canal
- having unusually tight anal sphincter muscles, which can increase pressure on the anal canal, making it more susceptible to fissures
In many cases, a clear cause cannot be identified.
Treatment for Anal Fissure from a Doctor
A doctor may prescribe medications to relieve your symptoms and speed up the healing process. This may include laxatives to help you go to the toilet more easily and pain-relieving ointments to apply directly to the anus. Surgery may be recommended for persistent cases of anal fissures where self-care measures and medications haven’t helped. Surgery is often very effective in treating anal fissures, but it carries a small risk of complications, such as temporary or permanent loss of bowel control (fecal incontinence).
Most anal fissures heal within a few weeks without treatment. However, they can easily recur if caused by untreated constipation. In some people, symptoms from anal fissures last for 6 weeks or more (chronic anal fissures).
How to Relieve Anal Fissure Symptoms
Adopting simple self-care measures can make it easier to go to the toilet. This will allow existing fissures to heal and reduce the chances of developing new fissures in the future.
Self-care measures to avoid constipation include:
- plenty of fiber in your diet, such as fruits, vegetables, and whole-grain bread, pasta, and rice – adults should consume at least 30 grams of fiber per day
- stay well-hydrated by drinking plenty of fluids
- don’t ignore the urge to go to the toilet
- exercise regularly – aim for at least 150 minutes of physical activity each week
Who is Affected
Anal fissures are quite common, affecting about 1 in 10 people at some point in their lives. Both men and women are equally affected, and people of all ages can experience them. However, children and young adults between the ages of 15 and 40 are more likely to develop anal fissures.
