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Anal Fissure: Causes, Prevention, and Treatments

Published on Dec 11, 2017 and last reviewed on Jun 23, 2022   -  5 min read


Pain in the anus is one of the most common complaints encountered in outpatient clinics. The patient sometimes describes the pain as 'my worst pain ever. This article provides some suggestions on how to avoid this annoying issue by making a few dietary and lifestyle changes.

Anal Fissure: Causes, Prevention, and Treatments

What Is an Anal Fissure?

An anal fissure is a tear or ulcer that develops in the lining of the anal canal after passing a hard motion. It affects one in ten people at some point in their lives. All age groups and both sexes are affected equally. The anal fissure produces pain and bleeding during bowel movements. Anal sphincter muscle, a ring muscle at the end of your anus, may exhibit spasms.

What Causes an Anal Fissure?

The following are the most common causes of anal fissure:

Less severe causes of an anal fissure are:

What Are the Signs and Symptoms of Anal Fissure?

Anal fissure has the following manifestations:

What Increases the Risk of Developing Anal Fissure?

  1. After Delivery: The occurence of anal fissures in women is common after childbirth.
  2. Constipation: The risk of developing anal fissures is increased in people who strain and pass hard stools during bowel movements.
  3. Anal fissures are common in people who have anal sex.
  4. Crohn’s Disease: The lining of the anal canal is inflamed in Crohn’s disease, which is an inflammatory bowel disease. This, in turn, makes it more sensitive and increases the chance of developing anal fissure.
  5. Age: Although anal fissures can occur at any age, middle-aged adults and infants have an increased risk.

What Is the Course of Anal Fissure?

Usually, it resolves over four to six weeks. But, it can recur if there is constipation or hard motion. In some people, the condition turns chronic and lasts for years. Few develop complications such as anal stricture and require surgery.

What Can We Do to Prevent Anal Fissures?

How Is an Anal Fissure Diagnosed?

Complete medical history is obtained from the patient, and a gentle physical examination of the anal fissure is done. In most cases, an anal fissure can be diagnosed with visual inspection as it is often visible.

The cause of the anal fissure can be determined from the location itself. An underlying disorder like Crohn’s disease causes an anal fissure that has an opening on the side rather than having it on the front or back.

An anal fissure can be diagnosed by:

In addition to physical examination, the following tests can be performed to determine the cause:

What Is the Treatment of Anal Fissures?

What Are the Complications of Anal Fissures?

  1. Chronic Anal Fissure: If the anal fissure does not respond to treatment in eight weeks, it is considered chronic anal fissure, which might require further treatment.
  2. Recurrence: Recurrence of anal fissures is common.
  3. Tear Extending to Surrounding Muscles: In some cases, an anal fissure may extend and reach the internal anal sphincter muscle, a ring of muscle responsible for keeping the anus closed. This makes the healing of anal fissures difficult and causes discomfort.

What Lifestyle Changes Help in Treating Anal Fissures?

  1. An anal fissure can be healed by keeping the stools soft by daily taking around 25 to 30 grams of fiber. Whole grains, fruits, vegetables, and nuts are fiber-rich foods. Fiber supplements can be taken if required, but it should be noted that fiber should be taken gradually, as it can produce abdominal bloating and gas problems.

  2. Constipation can be prevented by drinking adequate amounts of water.

  3. Straining during bowel movements should be avoided because it creates pressure that might cause a new tear or open up an already healed tear.

  4. In children with anal fissures, frequently changing the diapers and washing the area gently help promote healing.


Frequently Asked Questions


How Long Do Anal Fissures Last?

Usually, anal fissures heal within a few weeks without treatment. But they can recur and come back when they are caused by constipation that remains untreated. In chronic anal fissures, symptoms last for six weeks or more.


Can a Fissure Heal on Its Own?

In the case of acute anal fissures, they do not last longer than six weeks. They are common and usually heal on their own with self-care. Anal fissures that last longer than six weeks are called chronic anal fissures, and they may need surgery or medicine to help them heal.


Which Ointment Is Best for Fissures?

Nitroglycerin ointment is the most effective medicine for relaxing blood vessels and the anal sphincter and treating anal fissures. This ointment needs to be compounded by a compounding pharmacy.


What Is the Home Remedy for Anal Swelling?

The home remedies for anal swelling are,

- Warm baths that cover the legs help to reduce irritation and ease the swelling caused by hemorrhoids.

- Coconut oil helps to reduce the urge to scratch.

- Aloe vera helps with itching, swelling, and burning when applied to the anus.

- Applying ice packs may relieve pain and inflammation.

- Over-the-counter medications such as Acetaminophen or Ibuprofen may help.


Is Vaseline Good for Anal Fissures?

Vaseline or petroleum jelly is good for anal fissures as it helps to lubricate the anorectal area. In addition, soaking in a warm bath for 10 to 20 minutes several times a day, avoiding strained toilet or prolonged sitting on the toilet, and gently cleansing the anorectal area helps to relax the anal muscles.


Which Exercise Is Best for Anal Fissure?

Engaging in 30 minutes of moderate physical activity, such as walking and exercising most days of the week, helps with anal fissures. Exercise regulars the bowel movements and increases the blood flow to most parts of your body, so it promotes the healing of an anal fissure.


Does Sitting Add Benefits for Anal Fissures?

Regular sitting bath, that is, sitting in warm water up to the hips, helps to relax the anal sphincter. Sitting can be painful for people with anal fissures, and also they should not strain during bowel movements.


What Foods Are Good for Anal Fissure?

Most anal fissures heal by following good elimination habits, taking plenty of water and fiber, and avoiding constipation foods and popcorns, tortilla chips, or nuts.


What Is the Difference between a Fissure and a Hemorrhoid?

The difference is that they are each a different kind of injury, where anal fissure is a tear of tissue, hemorrhoids occur due to the weakening of cushions of tissue in the lower rectum. This causes the skin to swell up like a tiny balloon and fill with blood.


Is Hydrocortisone Good for Fissures?

Hydrocortisone is used to treat itching, minor pain, discomfort, and swelling caused by hemorrhoids and other problems of the anal area, such as itching, anal fissures, etc.

Last reviewed at:
23 Jun 2022  -  5 min read


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