Anal fissure

An anal fissure is a tear in the lining of the anus. It can cause severe pain during and after a bowel movement. The pain can last several minutes to several hours, and can recur with each bowel movement. Traces of bright red blood on the surface of the stool or on the toilet paper may also be present.

Individuals with an anal fissure may occasionally experience a ripping or burning sensation while defecating. Some may also note itching around the anus.

A persistent fissure can cause chronic constipation, mainly due to fear of painful defecation, which can in fact worsen the anal tear. Moreover, the anal sphincter (the muscle that keeps the anus closed) may be affected, causing painful spasms. These spasms may prevent proper blood flow to the anus, impairing healing of the anal fissure.

Anal fissures are most common among infants. Women who are pregnant or who have recently given birth also present a higher risk of developing fissures.

Causes and triggers

Some of the most common causes of anal fissures include:

• Constipation
• Passage of hard stool
• Diarrhea
• A chronic inflammatory disease of the intestines

And less commonly:

• Certain sexual practices
• An anal infection
• Certain cancers

Treatment

Prevention mainly consists of avoiding constipation by eating high-fiber foods, such as fruits and vegetables, drinking plenty of fluids, exercising regularly, and going to the bathroom when the urge is felt to keep from straining while on the toilet.

Oftentimes, the fissure will heal on its own within a few weeks.

Certain measures may be taken to soothe related pain and itching:

• Warm sitz baths for 10 to 15 minutes, 2 to 3 times daily, help improve blood flow which in turn promotes healing
• Application of a zinc oxide ointment
• Application of a pain relieving ointment

To help with bowel movements, a stool softener, fiber supplements or laxative may be used.

A healthcare professional may prescribe a product that must be applied on the area or a medication that relaxes the muscles around the anus. If the problem persists, surgery is an option.

When should I see a healthcare professional?

Individuals who have signs of an anal fissure should see their healthcare provider since symptoms can also be the result of other health conditions.