Anal Fissure

What is an Anal Fissure?

An anal fissure is a small crack or tear in the lining of the anal canal. It usually occurs when hard or large stools pass through the anus, causing a tear in the delicate skin and resulting in pain or bleeding during bowel movements.

What are the symptoms of an Anal Fissure?

  • Sharp pain during or after bowel movements that can last several hours
  • Bright red blood on stool or toilet paper
  • A visible crack or tear around the anus
  • A small lump or skin tag near the fissure
anal-fissure

What causes Anal Fissures?

Anal fissures are usually caused by:

  • Passing large or hard stools
  • Chronic constipation and excessive straining
  • Long-standing diarrhea
  • Anal intercourse
  • Childbirth (especially vaginal delivery)

What are the rare causes of Anal Fissure?

In some cases, fissures can occur due to underlying conditions such as:

  • Crohn’s disease or other inflammatory bowel diseases
  • Anal cancer
  • HIV infection
  • Tuberculosis
  • Syphilis

How is an Anal Fissure diagnosed?

Diagnosis is made through a clinical examination of the anal area to assess the fissure, its severity, and the presence of any skin tags.

In recurrent or chronic fissures, or when conditions like Crohn’s disease are suspected, doctors may recommend an ileo-colonoscopy for further evaluation.

When should you see a doctor?

You should consult a doctor if you experience:

  • Pain during bowel movements
  • Bleeding on stool or toilet paper
  • Persistent discomfort around the anus

Early treatment helps prevent chronic fissures and complications.

What are the complications of an Anal Fissure?

If left untreated, an anal fissure may lead to:

  • Failure to heal (chronic fissure)
  • Recurrence of fissures
  • Extension into the anal sphincter muscle, making healing more difficult
  • Fecal impaction (hard stool blockage)
  • Anal stenosis (narrowing of the anal canal)
  • Anal fistula (abnormal tract formation)

These two conditions are often confused:

  • A fissure is a painful tear in the anal lining.
  • Piles (hemorrhoids) are swollen blood vessels inside or outside the anus and are usually painless unless thrombosed.

What is the difference between Anal Fissure and Piles?

Both terminologies are used often and confusingly. Fissure is a split in the lining of anus and is painful. Piles or Hemorrhoids are painless, blood vessels of anal canal which descend down and outside the anus.

What are treatments for Anal Fissure?

In over 99% of cases, anal fissures heal with medical management. Treatment includes:

  • Laxatives to soften stools
  • Topical medications to improve blood flow and reduce pain
  • Sitz baths (sitting in warm water) to relax anal muscles and promote healing
  • Dietary changes such as eating fiber-rich foods, fruits, vegetables, and drinking plenty of water

Avoiding non-vegetarian and spicy foods helps in faster healing.

When is surgery needed for Anal Fissure?

Surgery is rarely required.
It is considered only in chronic, long-standing, non-healing fissures. The procedure, called Lateral Internal Sphincterotomy (LIS), involves making a small cut in the internal anal sphincter muscle to reduce tension and allow healing.

What are skin tags?

In chronic fissures, the skin around the anal opening may thicken and form a small lump or skin tag. These are not piles and not cancerous.

What is the treatment for skin tags ?

Painless skin tags are usually left alone. Small painful skin tags settle down on treatment of the anal fissure.

Very large painful ones need to be surgically excised.

Do anal fissures go away by themselves?

Most acute fissures heal naturally with dietary changes, laxatives, and local creams.

However, if your fissure hasn’t healed within a few weeks, it may be chronic and needs medical or surgical treatment.

How Long Do Anal Fissures Take to Heal?

Most acute fissures heal within a few days to weeks.Chronic fissures that last more than eight weeks may require treatment, and complete healing can take an additional 6–12 weeks with proper care.

How Can You Prevent Anal Fissures?

You can prevent fissures by:

  • Eating a high-fiber diet (fruits, vegetables, whole grains)
  • Drinking enough water daily
  • Avoiding constipation and straining during bowel movements
  • Walking regularly (at least 5 km/day) to improve bowel movement
  • Avoiding spicy foods and non-vegetarian meals that cause constipation

Frequently Asked Questions (FAQs)

What happens if left untreated

Untreated fissures may become chronic and lead to complications such as:

  • Fecal impaction
  • Anal stenosis
  • Anal fistula
    Early treatment prevents these and ensures complete recovery.
Can Stress or Diet Cause Anal Fissures?

Yes, both stress and diet can indirectly contribute to the development of anal fissures.

When you’re stressed, your digestive system often slows down, leading to constipation and hard stools — the most common triggers for anal fissures. Stress can also tighten the anal sphincter muscles, making bowel movements more painful and increasing the risk of small tears.

A poor diet low in fiber and fluids can make stools hard and difficult to pass, causing strain and injury to the anal lining. Consuming too much spicy, oily, or processed food can further irritate the anal area and worsen symptoms.

To prevent fissures, manage stress through relaxation techniques, stay hydrated, and maintain a fiber-rich diet with plenty of fruits, vegetables, and whole grains.

Can Home remedies cure Anal Fissures permanently?

Home remedies can help heal mild or acute anal fissures, but they may not cure chronic or long-standing fissures permanently.

Simple lifestyle changes like drinking plenty of water, eating a high-fiber diet, and taking sitz baths (sitting in warm water for 10–15 minutes, twice a day) can relieve pain and promote healing. Using stool softeners or natural laxatives like isabgol (psyllium husk) also helps reduce straining during bowel movements.

However, if the fissure has become chronic (lasting more than 6–8 weeks), it may not heal completely with home remedies alone. In such cases, medical treatment — including prescribed ointments that relax the anal sphincter — or minor surgery may be required for permanent relief.

At The Best Gastro Care Centre

Your Health, Our Priority

Our expert team provides world-class treatment for Anal Fissures and other gastrointestinal diseases using advanced techniques and compassionate care. We focus on providing lasting relief and promoting healing.

📞 Book your appointment today to consult our specialist gastro for timely diagnosis and treatment of Anal Fissures.