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Anal Fissure

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An anal fissure is a small tear or cut in the skin that lines the anus causing pain and often bleeding. Anal fissures are common occurrences.


The typical symptoms of an anal fissure are pain during or after passing a stool and bleeding. The pain associated with a bowel movement may cause you to avoid passing stool leading to constipation.

Other symptoms include:

  • Pain during bowel movements that can be severe
  • Pain after bowel movements that can last up to several hours
  • Bright red blood on the stool or toilet paper after a bowel movement
  • Itching or irritation around the anus
  • A visible crack in the skin around the anus
  • A small lump or skin tag on the skin near the anal fissure

Causes and Risk Factors

Most often anal fissures are caused by trauma to the skin around the anus or the tissue lining the anus. A hard, dry bowel movement is typically responsible for a fissure. Other causes of an anal fissure include diarrhea or inflammatory conditions of the anal area that weaken the tissues.

Common causes of anal fissure include:

  • Large or hard stools passing through the anal canal
  • Constipation and straining during bowel movements
  • Chronic diarrhea
  • Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease (IBD)

Less common causes of anal fissures include:

  • Anal sex
  • Cancer
  • HIV
  • Tuberculosis
  • Syphilis

Diagnostic Tests

Symptoms of anal fissures may mirror other conditions so it’s important to make appointment with your doctor if you have any symptoms that worry you. Your doctor will start with a complete medical history to determine the frequency and duration of your symptoms.

Your doctor may also perform additional tests to aid in diagnosis including:

  • Physical exam

Treatment and Procedures

Because anal fissures are often associated with other issues such as constipation and diarrhea, treating those issues can be the first step in treating the anal fissure.

Most anal fissures will heal without the need for surgery. Treatments include:

  • High fiber diet, stool softeners, and plenty of fluids to relieve constipation
  • Warm baths for 10-20 minutes several times each day to promote healing
  • Dietary changes as needed to relieve diarrhea

If the above treatments are unsuccessful or the fissures recur, your doctor may recommend surgery of the anal sphincter muscle to reduce spasm and pain and promote healing. Surgery is usually done on an outpatient basis.

Your health is our greatest concern. Please contact the Center for Colon & Rectal Surgery at 407.303.2615for a private consultation today.