Anal Fissures: Symptoms, Causes, and Treatments

Anal Fissures: Symptoms, Causes, and Treatments

General Surgery |by Dr. Somnath Mukherjee| Published on 30/01/2025

Dealing with an anal fissure can be a painful and isolating experience. The sharp pain, bleeding, and discomfort during bowel movements are hard to ignore, yet many people feel too embarrassed to seek help. 

However, people often get confused between haemorrhoids and anal fissures; although both conditions are different, they affect anus. Anal fissures are small tears in the anus's sensitive lining that can cause significant distress. The problem usually heals on its own if you make some changes to your diet and follow some simple treatments. 

This blog will help you understand what anal fissure is, its symptoms, causes and treatment options. If you're experiencing any such problem, don't ignore it. Contact Best Proctologist at CMRI Hospital, Kolkata today for expert consultation and treatment.

What is an anal fissure?

The anus is the opening in the human body through which stool passes out. When the anal tissue stretches beyond its normal limits, a cut or small tear occurs in the lining of the anus. This cut causes intense pain and bleeding during and after bowel movement.

“A fissure may develop if you have been passing hard and large stools that irritate the anal opening. Initially, they might not present symptoms, but as they progress, they can cause pain and significant bleeding during bowel movements. Anal fissure disease is more common in infants, but it can affect all ages," said Dr. Somnath Mukherjee, a leading gastroenterologist at the CK Birla Hospital, Kolkata (CMRI). 

What are the symptoms of anal fissure?

Here are the symptoms of an anal fissure:

  • Pain during and after bowel movements.
  • Bright red blood on stool or toilet paper. 
  • A visible crack near the anus.
  • A small lump or skin tag by the fissure.

Anal fissures are categorised as acute or chronic. Acute fissures often heal on their own within a few weeks with basic care. Chronic fissures, however, last longer than eight weeks and may need specialised treatment, like surgery to improve.

What causes an anal fissure?

Anal fissures occur when the skin around the anus is injured or irritated. This can result from various factors, with some being more common than others.

  • Passing hard or large stools (e.g., due to constipation).
  • Frequent diarrhoea.
  • Trauma during childbirth.

Less common causes include:

How to treat Anal Fissures

Anal fissures can be treated using three main approaches: conservative care, medication, and surgery. Here’s a breakdown of these options:

  1. Conservative Treatment

This is often the first step for healing anal fissures naturally. The goal is to reduce pain, heal the fissure, and prevent constipation. Key steps include:

  • Dietary changes: Eat high-fibre foods and drink plenty of water to soften stools.
  • Stool softeners: These can help ease bowel movements.
  • Warm baths: Taking warm sitz baths can soothe pain and promote healing.
  • Pain relief: Over-the-counter pain medications may also be helpful.

This approach is simple, safe, and effective for most people, with over 80% of fissures healing in 6–8 weeks.

  1. Medications

If conservative treatments aren’t enough, doctors may recommend medications such as:

  • GTN cream: It helps improve blood flow to the area but can cause side effects like headaches.
  • Calcium channel blockers: An alternative option if GTN doesn’t work.
  • Botox injections: It relaxes the anal muscles, helping the fissure heal. This is especially suitable for those at higher risk of complications from surgery.
  1. Surgery

For chronic or severe fissures that don’t respond to other treatments, surgery may be necessary. 

  • Lateral internal sphincterotomy: This involves a small cut in the sphincter muscle to reduce tension and promote healing.

It’s a minor procedure, often performed as day surgery, with a high success rate.

If you’re dealing with an anal fissure, remember that effective treatment options are available. Speak with your doctor to find the approach that works best for you.

The Final Word

Anal fissures are a more common health concern than you might think. It can cause you discomfort, pain and bleeding during and after bowel movement. But the good news is that they’re often treatable with simple remedies and lifestyle changes. 

CTA

If you’re experiencing pain, bleeding, or discomfort during bowel movements, don’t hesitate to seek help. Contact our experienced and trusted gastroenterologists today. Book your appointment at the CK Birla Hospital, Kolkata (CMRI).

FAQ

 

How long do anal fissures take to heal?

Most anal fissures heal within a few weeks with proper care, but chronic ones may take longer and need medical treatment.

Do anal fissures go away on their own?

Yes, many anal fissures heal on their own or with simple remedies, but persistent ones may require medical intervention.

Do anal fissures bleed?

Yes, anal fissures often cause bright red bleeding during or after bowel movements.

Can anal fissures get infected?

While rare, anal fissures can become infected, especially if left untreated or if there’s a complicating factor like an abscess.

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