Understanding Anal Fissures

An anal fissure is a small rip or tear in the lining of the anus. The anus is the opening where poop leaves the body.

Anal fissures are common. They are sometimes confused with hemorrhoids, which can cause similar symptoms.

Cross section of anus showing anal fissure.

What causes an anal fissure?

Having constipation or straining while pooping is the most common cause of an anal fissure. You can also get one from:

  • Diarrhea

  • Childbirth

  • Traumatic anal sex

Less commonly, a fissure may be caused by:

  • Inflammatory bowel disease

  • An anal infection

  • An anal tumor

Symptoms of an anal fissure

The main symptom of an anal fissure is sharp pain during a bowel movement. This pain may last a few minutes to hours after. You may also have:

  • Minor bleeding during or after a bowel movement

  • Itching or irritation around the anus

  • A small lump near the anus

Treatment for an anal fissure

Most anal fissures will get better with no or minor treatment. Your healthcare provider may advise:

  • Changes in your diet. Eating more fiber-filled foods, such as fruits and vegetables, can help keep your bowel movements regular. It can also make your stool easier to pass. So can drinking more water. Your healthcare provider may also tell you to take a fiber supplement if changes in your diet are not enough.

  • Stool softeners or laxatives. These medicines can help prevent constipation.

  • Sitz baths. Soaking in warm water for 10 to 20 minutes a day can help ease symptoms.

  • Medicines. Ointments, creams, and suppositories may help ease pain and aid with healing.

  • Botulinum toxin injections. This treatment may be used if an anal fissure is not healing well. It can help relax the anal sphincter muscles. This may increase blood flow to the area and help healing.

  • Surgery. Your healthcare provider may advise surgery if the anal fissure isn’t healing or keeps coming back. You’ll likely have a lateral internal sphincterotomy. During this procedure, a cut is made in the anal sphincter to lower pressure inside the anus and increase blood flow. One possible complication of surgery is fecal incontinence.

When to call your healthcare provider

Call your healthcare provider right away if any of the following occur:

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Ongoing rectal bleeding

  • Symptoms that don’t get better, or get worse

  • New symptoms

© 2000-2023 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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