Anal Fissure

What is an anal fissure?

An anal fissure is a painful tear in the lining of the anus. Typical symptoms are pain and light red bleeding when having a bowel movement. It is important to rule out other conditions which may also lead to anal or rectal bleeding. Treatment consists of softening the stool, avoiding constipation and practicing good hygiene. Most anal fissures will heal within 6-8 weeks. Ongoing or chronic fissures can also be treated with medication and ointments. Surgery is required infrequently to repair the tear.

Risks

An anal fissure can occur when there is overstretching of the anal canal, which causes the lining to tear. This most commonly occurs when passing hard or large stools, when a person strains to open their bowels, or if there is an infection in the area which causes the tissues to become soft and fragile. People with inflammatory bowel conditions, such as ulcerative colitis or Crohn's disease may also get anal fissures as a part of their condition.

Symptoms

The most noticeable symptom is a sharp pain felt during and after opening the bowels. This may cause the anus to tighten reflexively. Small amounts of light red blood are often seen when wiping the bottom.

Diagnosis

Diagnosis is based on reviewing the affected person's history and conducting a physical examination of the anal region. If an underlying infection is suspected, further investigation may be needed to confirm the cause.

Treatment

The most important treatment is to soften stool and prevent constipation. Anal fissures can be treated with ointments which relax the anal muscle and may also contain numbing substances. A hip bath, where the person sits in water up to the hips, may also be helpful to keep the anal region clean. If the fissure is large, or becomes infected, surgery may be needed to thoroughly clean away infected tissue and repair the tear.

Prevention

Preventing constipation can help to prevent some anal fissures. This can be done by eating fiber-rich foods, drinking plenty of water and exercising regularly. Avoiding straining when opening the bowels and maintaining good hygiene when using the toilet are also important.