Anal Fissure

Written by Rose Kivi and Matthew Solan | Published on July 25, 2012
Medically Reviewed by George Krucik, MD on July 25, 2012


An anal fissure is a small cut or tear in the skin lining the anus. Childbirth, straining during bowel movements, or bouts of constipation or diarrhea can all tear the anal lining. Anal fissures are usually not a cause for concern and most heal without any medical treatment. However, those resistant to treatment may require surgery.

What are the Symptoms of Anal Fissures?

With an anal fissure, you may experience one or more of the following symptoms:

  • a visual tear on the anus
  • a skin tag (small lump of skin) next to the anal fissure
  • extreme pain in the anal area during bowel movements
  • streaks of blood on stools or on tissue paper after wiping
  • burning or itching in the anal area

What Causes Anal Fissures?

The skin around the anus can be torn when passing large or hard stools. Chronic constipation or frequent diarrhea can also tear the skin. Other causes:

  • Crohn’s disease or another irritable bowel disease
  • straining during childbirth
  • decreased blood flow in the anorectal area due to old age
  • overly tight or spastic anal sphincter muscles

How Is The Condition Diagnosed? How Is It Treated?

A doctor can usually diagnose an anal fissure with just a visual exam. However there may be a need to insert an endoscope (a small lighted tube) or anoscope into your rectum to make it easier to see the tear.

Most anal fissures heal with just home care treatments like adding fiber supplements to your diet or using over-the-counter stool softeners. Warm baths can relax the anal muscles, relieve irritation, and increase blood flow to the area. There are also over-the-counter ointments, such as Anusol-HC, that can soothe some of the discomfort.

Topical pain relievers, such as Lidocaine, applied to the anus can help relieve the pain. Your doctor can also suggest a brand of calcium channel blocker ointment that can relax the sphincter muscles and allow the anal fissure to heal.A topical nitroglycerin ointment applied to the anus widens the blood vessels in the anus, encouraging blood flow to the area, will also promote healing.

Another treatment is Botox injections into the anal sphincter. This will prevent spasms in the anus by temporarily paralyzing the muscle. The purpose is to allow the anal fissure to heal while preventing new fissures from forming.

If your anal fissure fails to respond to other treatments your doctor may recommend an anal sphincterotomy. This is a surgical procedure where a small incision is made in the anal sphincter to relax the muscle, which allows the anal fissure to heal.

Who Is At Risk For Developing Anal Fissures?

For unknown reasons, anal fissures are common during infancy. They occur in approximately 80 percent of babies during the first year of life. Older adults are also prone to anal fissures due to decreased blood flow in the anorectal area. During and after childbirth, women are at risk because of the straining during delivery.

If you have an inflammatory bowel disease, such as Crohn’s disease, you have a higher risk of developing anal fissures. This is because the inflammation in the intestinal lining makes the tissue more prone to tearing. You are at risk of developing anal fissures if you experience frequent constipation where you have to strain to pass stools.

How Can Anal Fissures Be Prevented?

Although anal fissures cannot always be prevented, you can reduce your risk of getting one with the following guidelines:

  • to prevent anal fissures in infants, change diapers frequently
  • keep the anal area dry
  • cleanse the anal area gently
  • avoid constipation by drinking plenty of fluids, eating plenty of fiber, and exercising regularly
  • treat diarrhea immediately
Was this article helpful? Yes No

Thank you.

Your message has been sent.

We're sorry, an error occurred.

We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later.

Show Sources

Trending Now

Famous Athletes with Asthma
Famous Athletes with Asthma
Asthma shouldn’t be a barrier to staying active and fit. Learn about famous athletes who didn’t let asthma stop them from achieving their goals.
Easy Ways to Conceal an Epinephrine Shot
Easy Ways to Conceal an Epinephrine Shot
Learn how to discreetly carry your epinephrine autoinjectors safely and discreetly. It’s easier than you think to keep your shots on hand when you’re on the go.
Beyond Back Pain: 5 Warning Signs of Ankylosing Spondylitis
Beyond Back Pain: 5 Warning Signs of Ankylosing Spondylitis
There are a number of potential causes of back pain, but one you might not know about is ankylosing spondylitis (AS). Find out five warning signs of AS in this slideshow.
Numbness, Muscle Pain and Other RA Symptoms
Numbness, Muscle Pain and Other RA Symptoms
The symptoms of RA are more than just joint pain and stiffness. Common symptoms include loss of feeling, muscle pain, and more. Learn more in this slideshow.
How to Evaluate Your Multiple Sclerosis Treatment Plan
How to Evaluate Your Multiple Sclerosis Treatment Plan
Every multiple sclerosis (MS) patient is different, and no single treatment plan works for everyone. Learn more about what to consider when evaluating your MS treatment plan.