Information and Treatment for Anal Fissure
What Is an Anal Fissure?
An anal fissure is a tear or ulcer in the lining of the anal canal, which carries stool out of the body. An anal fissure can either be acute (shallow and of short duration) or chronic (deeper, perhaps reaching muscle, and persisting for six weeks or more).
What Causes an Anal Fissure?
Most anal fissures occur when a hard, dry stool tears the delicate lining (anoderm) of the anus. Sometimes an anal fissure is caused by an extended bout of diarrhea, irritable bowel disease, or sexually transmitted disease. Pregnancy and childbirth can lead to anal fissures.
How Common Are Anal Fissures?
Anal fissures are quite common. About one in every 10 people will have an anal fissure at some point in their life.
They affect both sexes equally and people of all ages can get them.
What Are the Common Symptoms of an Anal Fissure?
Common symptoms of an anal fissure are:
- Sharp pain when you’re moving your bowels, followed by a burning sensation that can last hours
- Bleeding when you defecate, indicated by bright-red blood on the stool or toilet tissue
How Is an Anal Fissure Diagnosed?
Your health care provider will ask you about your symptoms and the type of pain you've been experiencing. They may also ask about your toilet habits. They'll usually be able to see the fissure by gently parting your buttocks.
What Can I Do about an Anal Fissure?
To avoid an anal fissure caused by constipation, keep your bowels regular and stools soft by getting plenty of fiber in your diet or taking supplementary fiber, and drinking plenty of water, six to eight 10-ounce glasses a day.
You can soothe the pain of an anal fissure with acetaminophen or ibuprofen, use topical anesthetics that contain lidocaine, and take sitz baths (sit in warm water for 10 to 20 minutes) several times a day. The soaks promote relaxation of the anal muscles, which may hasten healing.
What Treatment Is Available for an Anal Fissure?
Anal fissures usually heal within a few weeks without the need for treatment. Your health care professional may recommend applying medicated ointment, taking soothing sitz baths (sitting in warm water), and taking over-the-counter analgesics. Narcotic pain medications are not recommended, as they promote constipation.
If surgery is necessary, it is curative in 90 percent of chronic anal fissures.
When Should I See My Doctor?
See your health care provider if you think you have an anal fissure. Don't be embarrassed: Anal fissures are a common problem that they are accustomed to dealing with.
Most anal fissures get better without treatment, but your physician will want to rule out other conditions with similar symptoms. They can tell you about treatments that can relieve your symptoms, and advise you about steps you can take to reduce the risk of a fissure recurring. The Women’s Medicine Collaborative has physicians who can help.