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Anal Fissure

WHAT IS AN ANAL FISSURE?

An anal fissure is a tear in the skin of the anus that results after the passage of hard stool or from the trauma of excessive wiping.

WHAT ARE THE SYMPTOMS OF AN ANAL FISSURE?

Symptoms of an anal fissure may include:

  • Anorectal pain
  • Bright red bleeding from the anorectal area
  • Itching in the anorectal area

WHAT CAUSES AN ANAL FISSURE?

Anal fissures are often caused from hard stools or excessive wiping. Other causes may include:

  • Chronic constipation
  • Straining during bowel movements
  • Chronic diarrhea
  • Anal intercourse
  • Childbirth

HOW ARE ANAL FISSURES DIAGNOSED?

Anal fissures are typically diagnosed by noting a patient’s symptoms and performing a physical exam. If it appears  may have an underlying condition in addition to an anal fissure, the doctor may recommend further testing.

HOW ARE ANAL FISSURES TREATED?

50% of anal fissures will heal with non-surgical therapy after they have been present for more than 3 months. Non-dietary therapies may include stool softeners, fiber supplements, warm baths or sitz baths and regular exercise.

Doctors may prescribe ointments to increase blood flow and promote healing. Other medications include creams to reduce pain and calcium channel blocking ointments. These ointments relax the internal sphincter muscle and increase the flow of blood to the anal fissure.

At Loma Linda University Health, anal fissure is treated with a customized care plan for the individual patient. Because we focus on whole person care, we may emphasize an increase in diet changes such as increased fiber intake and increasing daily fluids. These measures can keep stools soft to avoid straining during bowel movements.

If no significant improvement is seen in the symptoms, the fissure’s inability to heal is typically due to spasm of the sphincter muscles and the lack of appropriate blood flow to the fissure. In these cases, a surgical procedure may be recommended.

WHAT ARE THE COMPLICATIONS OF ANAL FISSURE?

Complications of anal fissures can include:

  • Failure to heal, requiring surgery
  • Recurrence of anal fissure
  • A tear that extends into the surrounding muscles

WHO IS AT RISK OF DEVELOPING ANAL FISSURES?

People most likely to develop anal fissures are those who experience chronic constipation or diarrhea. Others at risk include women who have given birth, people with Crohn’s disease, and those who practice anal intercourse. While anal fissures can occur at any age, they are most common in infants and middle-aged adults.

NEXT STEPS

Seek medical intervention. Being proactive is important, and it starts with a medical evaluation. If you believe you may have an anal fissure, request an evaluation at Loma Linda University Health. Contact your care provider or schedule the appointment through MyChart