The anus, the muscular opening at the end of the digestive tract where stool exits the body, is called anal fissure. When a person has an anal fissure, they can experience pain, bleeding, and spasms in the anal sphincter before and after bowel movements. It affects people of all ages, but it is more common in infants and middle-aged individuals.
Constipation often causes trauma to the anal canal, resulting in anal fissures. Other factors that can cause anal fissures include:
Straining during bowel movements
Long-lasting diarrhea
Anal intercourse
Childbirth
Inflammatory bowel disease (such as Crohn’s disease)
Anal cancer
HIV
Tuberculosis
Syphilis
Anal fissures are characterized by the following symptoms:
Up to several hours of pain during and after bowel movements
After a bowel movement, red blood appears on the toilet paper or stool
Around the anus, there is a visible crack in the skin
Near the anal fissure, there is a small lump or skin tag
Your doctor will examine your anus and rectum to look for signs of an anal fissure. They will also ask you about your symptoms and medical history. A small instrument known as an anoscope is sometimes used to see inside the anal canal. The doctor may order some tests to rule out other conditions if the cause of your anal fissure is unclear.
Inflammatory or infectious blood tests
Blood or parasite tests in the stool
Examination of the colon and rectum for polyps, tumors, or inflammation by colonoscopy
The majority of anal fissures heal on their own within a few weeks with proper care and hygiene. However, some may become chronic and require medical treatment.
Here are some home remedies you can try to ease your symptoms and promote healing:
To prevent constipation and hard stools, use over-the-counter stool softeners
Staying hydrated and improving digestion by drinking more fluids
By taking fiber supplements and eating more fibrous foods, you can bulk up your stools and make them easier to pass
You can relax your anal muscles, relieve irritation, and increase blood flow to the area by taking a sitz bath (a warm-water bath that covers your hips and buttocks)
To reduce inflammation and dilate the blood vessels, apply nitroglycerin ointment or hydrocortisone cream to the anus
Topical pain relievers, such as lidocaine, can be applied to numb the area and ease discomfort
The following medications may be prescribed by your doctor if home remedies are not enough to heal your anal fissure:
Medications that relax the sphincter muscles and improve blood flow to the area (such as diltiazem or nifedipine)
Injections of Botox that temporarily paralyze the sphincter muscles and prevent spasms
Infections that may be causing or complicating your anal fissure may be treated with antibiotics or antifungal drugs
A surgeon may recommend surgery if your anal fissure does not respond to other treatments or keeps returning. The most common surgical procedure for anal fissures is an anal sphincterotomy. An internal sphincter muscle is cut to reduce its tension and heal the fissure. While this surgery is usually effective and has few complications, some patients may have difficulty controlling gas or stools (incontinence).
Constipation and straining during bowel movements can cause an anal fissure. Some tips to avoid constipation include:
Including plenty of fruits, vegetables, whole grains, and lean proteins in a balanced diet
Throughout the day, drink enough water and other fluids
Exercise regularly to improve your health and stimulate your bowel movements
Foods that cause diarrhea or gas, such as spicy, fatty, or fried foods, dairy products, caffeine, alcohol, or artificial sweeteners, should be avoided
Stress and anxiety can affect digestion and bowel habits
Not holding it in for too long when you feel the urge to go to the bathroom
If you have any questions or concerns about your anal fissure, you should consult your doctor for advice and treatment. Most anal fissures are not serious conditions, but if left untreated, they can affect your quality of life and cause complications. If you treat your anal fissure properly, it can heal and prevent recurrence.
