Anal Fissure

What is an anal fissure?

 

An anal fissure is a tear in the lining of the anus, the opening where your bowel movements come out. Anal fissures cause pain, especially during a bowel movement.

There is a muscle that wraps around the anus and holds it shut. It is called the “anal sphincter.” The sphincter gets tense when the anus is injured. In people with anal fissures, the sphincter goes into spasms, which can lead to further injury.

What causes anal fissures? 

Having a hard, dry bowel movement most often causes an anal fissure.

What are the symptoms of an anal fissure? 

Most people who have an anal fissure feel a tearing, ripping, or burning pain when they have a bowel movement. This pain can last for hours. Some people also bleed slightly when they have a bowel movement. They might see bright red blood on the toilet paper or on the surface of the bowel movement. Some people with an anal fissure also have itching or irritation around the anus.

Should I see my doctor? 

Yes. See your doctor or nurse if you bleed when you have a bowel movement.

Are there tests I should have? 

Your doctor or nurse can check whether you have anal fissure by gently spreading your buttocks apart and looking at your anus.

If you have had bleeding, your doctor or nurse might send you for a test called a colonoscopy. For these tests, the doctor puts a thin tube into your anus and advances it into your colon. The tube has a camera attached to it, so the doctor can look inside your colon and check for causes of bleeding.

What can I do on my own to help an anal fissure? 

You can:

• Eat more fiber – Eating more fiber can help keep your bowel movements soft. Fiber is found in most fruits, vegetables, and whole grain. Doctors suggest eating 20 to 35 grams of fiber a day. The nutrition label on packaged foods can show you much fiber you are getting in each serving.
• Take a stool softener – Stool softeners are medicines that help make your bowel movements easier to pass. You can buy them without a prescription.
• Soak your buttocks in a “sitz bath” – Soaking your buttocks in 2 or 3 inches of warm water is called taking a “sitz bath.” Do this 2 to 3 times a day for 10 to 15 minutes. Do not add soap, bubble bath, or anything else to the water. Sitz baths help relieve pain and relax the sphincter.

How are anal fissures treated? 

Treatment for anal fissures involves steps that are similar to the things you can do on your own.

For the first month of treatment, doctors recommend that people:

• Take fiber supplements.
• Use a cream that relieves pain and helps the anus heal.
• Take sitz baths (see above).

If these steps to do not work, doctors can try other treatments, which can include surgery.