An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter).
Anal fissures are very common in young infants but can affect people of any age. An anal fissure usually heals on its own within four to six weeks. If it doesn't, medical treatment or surgery usually can relieve discomfort.
Signs and symptoms of an anal fissure include:
When to see a doctor
Common causes of anal fissure include:
Less common causes of anal fissures include:
Factors that may increase your risk of developing an anal fissure include:
Complications of anal fissure can include:
Preparing for your appointment
If you have an anal fissure, you may be referred to a doctor who specializes in digestive diseases (gastroenterologist) or a colon and rectal surgeon.
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Questions to ask your doctor
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Your doctor will likely ask about your medical history and perform a physical exam, including inspection of the anal region. Often the tear is visible. Usually this exam is all that's needed to diagnose an anal fissure.
Your doctor will probably refrain from performing a digital rectal exam, which involves inserting a gloved finger into your anal canal, because it is likely to be too painful. If anal fissure is suspected but can't be identified, your doctor may use a short, lighted tube (anoscope) to inspect your anal canal.
The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. If an underlying condition is suspected, your doctor may recommend further testing:
Treatments and drugs
Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing.
If your symptoms persist, you'll likely need further treatment.
Lifestyle and home remedies
Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences:
If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your infant's doctor.
You may be able to prevent an anal fissure by taking measures to prevent constipation. Eat high-fiber foods, drink fluids and exercise regularly to keep from having to strain during bowel movements.
Last Updated: 2012-12-04
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