Anal Fissure

What is an anal fissure?

An anal fissure is a tear in the lining of the anus, right at the verge of the anus. Anal fissure causes pain during a bowel movement.

There is a muscle that wraps around the anus and control it shut. This muscle is called the “anal sphincter”. The anal muscle gets tense when the anus is injured. When patients have anal fissures, the anal muscle goes into spasms, which can lead to further injury.

What causes anal fissure?

An anal fissure is usually caused by having a hard, dry bowel movement or constipation.

What are the symptoms of an anal fissure?

People who have an anal fissure will feel a sharp, tearing or burning pain when they have a bowel movement. This pain may last for a few hours. Slight bleeding may also happen when they have a bowel movement. They may see bright red blood on the toilet paper or in the toilet bowl. Some people with an anal fissure also have itching or irritation around the anal region. You should see your doctor if you bleed when having a bowel movement.

How are anal fissures treated?

Your doctor can check whether you have anal fissure by gently spreading your buttocks apart and looking at the anus. If you have bleeding, a colonoscopy test may be necessary. Colonoscopy looks inside your colon and check for causes of bleeding.

You should eat more fibre to help keep your bowel movement soft. Fibre is found in fruits, vegetables and in whole grains. You can soak your buttocks in a warm bath to help relieve the pain and relax the anal sphincter. Your doctor may give a stool softener to make your bowel movement softer and easier to pass. A muscle-relaxant cream can also be prescribed to relieve pain and help the fissure heal.

If medical treatment does not work, a small number of patients may need minor surgery to help the anal sphincter muscle relax to allow the fissure to heal.