Anal Fissure

What is an anal fissure?

  • It is a tear in the lining at the opening of the anal canal
  • This tear can cause severe pain and bleeding with bowel movements

What are the symptoms of an anal fissure?

  • A sensation of “tearing or cutting” pain can occur, during and especially after a bowel movement
  • Bright red blood may be seen on the toilet paper, on the stool or in the toilet water
  • Spasms to the sphincter muscle may occur during and after a bowel movement
  • The patient begins to fear having a bowel movement or may try to avoid having a stool due to the pain

What causes an anal fissure?

  • The sphincter muscle may be too tight (have increased muscle tone)
  • Hard, dry stools are usually the cause but loose stools and diarrhea due to increased frequency can also lead to a fissure
  • Decreased blood flow to certain areas of the sphincter muscle causes poor wound healing
  • Use of topical steroids can lead to poor wound healing

What is the treatment for an anal fissure?

  • It is important to keep your stool soft, but formed and bulky with a diet high in fiber or use of stool softeners
  • Topical cream that includes a medication for pain relief and one that increases blood flow is prescribed for at least 6 weeks to allow for healing
  • Narcotic pain medication is not recommended due to the side effect of constipation
  • Surgical treatments are only used if medical therapy is not successful