Anal Fissure

An Overview

An Anal fissure is a small cut or tear in the lining of the anus. The crack in the skin causes severe pain and some bright red bleeding during and after bowel movements. At times, the fissure can be deep enough to expose the muscle tissue underneath. An anal fissure is a small tear in the skin of the anus that can be caused by passing a large or hard poo. Some people may experience sudden and severe muscle cramps in their anal canal. These spasms are more likely to occur at night than at other times. Some people may experience several episodes of anal pain and then go long periods without any problems.

An anal fissure usually isn’t a serious condition. It can affect people of all ages, and it’s often seen in infants and young children since constipation is a common problem in these age groups. This is a tiny tear in the thin external skin of the anus, which despite its small size can be extremely painful. Anal fissures often are caused by passage of very hard stool, but can also occur from the irritation of severe diarrhea.

In most cases, the tear heals on its own within four to six weeks. In cases where the fissure persists beyond eight weeks, it’s considered chronic.

Symptoms of an Anal fissure 

  • A severe, sharp pain when doing a poo.
  • A visible tear in the skin around your anus.
  • Blood on toilet tissue or wipes.
  • A visible crack or tear in the anus or anal canal.
  • Burning and itching that may be painful.
  • Discomfort when urinating, frequent urination or inability to urinate.
  • Foul-smelling discharge.
  • A Skin tag  or small lump of skin, next to the tear.
  • sharp pain in the anal area during bowel movements.
  • a burning or gnawing pain that lasts several hours after doing a poo.
  • Streaks of blood on stools or on toilet paper after wiping.
  • burning or itching in the anal area.
  • Rectal bleeding you may notice a small amount of blood on the toilet paper after you wipe.

Causes for Anal fissure

An anal fissure most often occurs when passing large or hard stools. Chronic constipation or frequent diarrhea can also tear the skin around your anus. Other common causes include: An anal fissure can occur when someone passes a large or hard stool (poop), which stretches the lining of the anus until it tears. It also can happen when frequent diarrhea irritates the lining. An anal fissure can cause pain or itching in the area, especially during and after bowel movements. You may also see blood on the stool, baby wipes, or toilet tissue. In infants, anal fissures are very com. Causes can include diarrhea and constipation as well as straining to pass large stool. In addition, sometimes childbirth causes trauma to the anus which leads to fissures. If a fissure is allowed to persist untreated, it can become chronic.

  • Straining during childbirth or bowel movements.
  • Prolonged diarrhea.
  • Anal sex, anal stretching.
  • Insertion of foreign objects into the anus.
  • Inflammatory bowel disease.
  • Decreased blood flow to the anorectal area.
  • Overly tight or spastic anal sphincter muscles.
  • Anal Cancer.
  • Longstanding poor bowel habits.
  • Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus).
  • Scarring in the anorectal area.
  • HIV.


Usually, your doctor can diagnose an anal fissure by visual inspection of the anus or by gentle exam with the tip of the finger. As the symptoms vary from person to person and are similar to other medical conditions, similar conditions must be ruled out before making a definite diagnosis. These conditions can include hemorrhoids, abscesses, and fissures. During this exam, the doctor may insert a scope into your rectum to make it easier to see the tear. This medical instrument is a thin tube that allows doctors to inspect the anal canal. Diagnosis involves a thorough medical examination, including of the genital region.


  • Externally applied nitroglycerin(Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter.
  • Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief.
  • Using over the counter stool softeners.
  • Preventing constipation through the use of stool softeners, drinking more fluids while avoiding caffeine containing products (which cause dehydration), and dietary adjustments increase in intake of high fibre foods and fiber supplements.
  • Soaking in a warm bath (also called a sitz bath), 10 to 20 minutes several times a day, to help relax the anal muscles.
  • Taking fiber supplements and eating more fibrous foods such as raw fruits and vegetables.
  • Taking a sits bath to relax the anal muscles, relieve irritation, and increase blood flow to the anorectal area.
  • Avoiding straining or prolonged sitting on the toilet;
  • Using petroleum jelly to help lubricate the anorectal area.
  • If you experience prolonged burning pain after passing stools, your doctor may recommend taking common painkillers, such as paracetamol or ibuprofen which you can buy from a pharmacy or supermarket.
  • The surgery can usually be performed on an outpatient basis (the patient goes home the same day). Pain is relieved after a few days and complete healing takes place in a few weeks.
  • Botulinum toxin is a relatively new treatment for anal fissures. It’s usually used if other medicines haven’t helped.


An anal fissure can’t always be prevented, but you can reduce your risk of getting one by taking the following preventive measures:

  • Keeping the anal area dry
  • Cleansing the anal area gently with mild soap and warm water
  • Drinking plenty of fluids, eating fibrous foods and exercising regularly to avoid constipation
  • Treating diarrhea immediately
  • Changing infants’ diapers frequently
  • Using over-the-counter stool softeners.
  • Drinking more fluids.
  • Taking fiber supplements and eating more fibrous foods, such as raw fruits and vegetables.
  • Applying a nitroglycerin ointment to promote blood flow to the area or a hydrocortisone cream

Hope this Symptoms and cure article will be helpful to all. Do not forget to share your valuable suggestions if any.

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