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An anal fissure is a break in the skin of the anus. It can affect people of all ages but is most common in infants and middle-aged adults.

It usually isn’t a serious condition, and most people can treat it at home. However, recurring anal fissures or ones that don’t readily heal can be cause for concern.

Read on to learn more about the causes of anal fissures and what you can do to treat and prevent them in the future.

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.

Certain treatments can promote healing and help relieve discomfort, including stool softeners and topical pain relievers.

In most cases, the tear heals on its own. In cases where the fissure persists beyond 6 weeks, it’s considered chronic.

If an anal fissure doesn’t improve with these treatments, you may need surgery. Or your doctor may need to look for other underlying disorders that can cause anal fissures.

Most anal fissures don’t require extensive treatment. However, certain home remedies can help promote healing and relieve uncomfortable symptoms. You can treat an anal fissure at home by:

  • using over-the-counter stool softeners
  • drinking more fluids to stay hydrated and improve digestion
  • taking fiber supplements and eating more fibrous foods
  • taking a sitz bath to relax the anal muscles, relieve irritation, and increase blood flow to the anorectal area
  • applying nitroglycerin ointment to promote blood flow to the area or hydrocortisone cream, such as Cortizone 10
  • applying topical pain relievers, such as lidocaine, to the anus to ease discomfort

If your symptoms persist after trying home remedies, you should consult your doctor, who may recommend further treatments.

A calcium channel blocker ointment can relax the sphincter muscles and allow the anal fissure to heal.

Another possible treatment is Botox injections into the anal sphincter. The injections will prevent spasms in your anus by temporarily paralyzing the muscle. This allows 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 surgical procedure involves making a small incision in the anal sphincter to relax the muscle. Relaxing the muscle allows the anal fissure to heal.

However, this procedure comes with a small risk of permanent incontinence, meaning you may no longer be able to control when you pass stool.

Shop for stool softeners and Cortizone 10 online.

An anal fissure may cause one or more of the following symptoms:

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.

However, not all anal fissures are a sign of low-fiber diets and constipation. Poorly healing fissures or those located in a position other than the posterior and midline portion of your anus may indicate an underlying condition.

Other causes include:

  • straining during childbirth or bowel movements
  • having inflammatory bowel disease (IBD), such as Crohn’s disease
  • having decreased blood flow to the anorectal area
  • having overly tight or spastic anal sphincter muscles
  • engaging in anal sex
  • inserting objects into the anus

In rare cases, an anal fissure may develop due to:

Most anal fissures will heal without surgical intervention. Anal fissures are open wounds, so keeping the area clean and dry will assist in the body’s natural healing processes.

Eating a high-fiber diet, drinking plenty of fluids, taking sitz baths, and using anti-inflammatory ointments can help current fissures heal and prevent new ones.

Below is an illustration of where a chronic anal fissure may occur.

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1538375-Endotracheal Intubation Illustration by Ruth Basagoitia 1565979-Anal_Fissure 1565979-Anal_Fissure

A high-fiber diet can help keep your stools regular and easily passable. This is a key factor in preventing future anal fissures.

A daily fiber intake of 25–35 grams is suitable for most adults. Alongside an increase in dietary fiber, it’s essential to drink plenty of fluids per day. This helps to soften stools, makes them easier to pass, and helps promote good wound healing.

You may wish to take fiber supplements to increase your daily intake.

A range of fiber supplements is available for purchase online.

Anal fissures can be painful. This pain will be sharpest when you’re passing stools and may linger for some time after.

Topical pain reliever creams, like lidocaine creams, can also provide targeted relief, while anti-inflammatory pain relievers, such as ibuprofen, may help with more general pain symptoms.

Frequent warm baths may help relax muscles in the anus and promote fissure healing. This may help to reduce some symptoms of pain.

Shop for lidocaine ointments here.

You can’t always prevent anal fissures, 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 if they have the condition

Anal fissures may cause sharp pain and small amounts of bright red blood with bowel movements.

Sustained or repeated trauma to the area is the most frequent cause of anal fissures. Childbirth, anal sex, and the passing of hard stools are all common reasons for anal fissures.

Other conditions associated with anal fissures include previous anal surgeries, inflammatory bowel disease, local cancers, and sexually transmitted infections.

You can normally treat anal fissures at home with good wound hygiene, and avoid recurrences by making small dietary and lifestyle changes.

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