What is an anal fissure?

An anal fissure is a small tear or cut in the skin lining the anus, which can cause pain and/or bleeding. The tear can result from a hard, dry bowel movement. It can also occur due to diarrhea and inflammation of the anorectal area.

Fissures can be acute (recent onset) or chronic (present for a long time or recurring frequently). An acute fissure is usually caused by altered bowel habits, while a chronic fissure may be due to poor bowel habits, overly tight or spastic anal sphincter muscles, scarring or an underlying medical problem.

Anal fissures do not lead to colon cancer. Persistent symptoms require careful evaluation, however, since these symptoms can be caused by other conditions, too.

What are the symptoms of an anal fissure?

The typical symptoms are extreme pain during defecation and red blood streaking the stool. Patients may try to avoid defecation because of the pain.

A Happy Ending

“More than 90% of the patients who require [surgical intervention] have no further problems with anal fissures. For the remaining 10%, further assessment may need to be performed, including anal manometry testing or an exam under anesthesia.”

How do you treat an anal fissure?

Over 90% of the time, acute fissures are managed without surgery. A high fiber diet, fiber supplements, stool softeners and plenty of fluids are recommended to avoid constipation and promote the passage of soft stools. Warm baths for 10-20 minutes several times a day are soothing and promote relaxation of the anal muscles. Occasionally, special medicated creams are recommended.

A chronic fissure is one that lasts longer than one month and may require additional treatment. Depending on the appearance of the fissure, other medical problems such as inflammatory bowel disease or infections may be considered and testing might be recommended. A manometry test may be performed to determine if analy sphincter pressures are high. Also, an examination under anesthesia might be recommended to determine if a definite reasons exists for lack of healing.

A fissure that fails to respond to treatment, should be re-examined to find out why. There might be scarring or muscle spasm of the internal anal sphincter muscle. If necessary, surgery can be performed to correct the condition.