An anal fissure is a small tear in the skin that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. An anal fissure typically causes pain and bleeding with bowel movements.
Anal fissures most often affect people in middle age, but fissures also are the most common cause of rectal bleeding in infants. Most anal fissures heal within a few weeks with treatment for constipation, but some fissures may become chronic. If an anal fissure doesn't heal, medical treatment or surgery can usually relieve discomfort.
Signs and symptoms of an anal fissure include:
When to see a doctor
More 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're likely to start by seeing your family doctor or a general practitioner. You may be referred to a 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
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important, in case time runs out. For anal fissure, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime you don't understand something.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Your doctor will likely ask you for your medical history and perform a physical exam, including inspection of the anal region. Often the tear is visible. Usually this is all that's needed to diagnose an anal fissure.
Your doctor may refrain from performing a rectal exam, which involves inserting a gloved finger into your anal canal, because it may be too painful. In some cases, however, your doctor may use a short, lighted tube (anoscope) to inspect your anal canal and see how far an anal fissure extends.
If your signs and symptoms suggest you might have an underlying disorder such as Crohn's disease or colorectal cancer, your doctor may recommend further testing:
Treatments and drugs
Anal fissures often heal within a few weeks if you take steps to keep your stools soft and treat constipation or diarrhea. If the tear doesn't heal within six to eight weeks, however, you'll likely need medical treatment or possibly surgery.
If your infant has been diagnosed with an anal fissure, change your child's diaper regularly and keep the anal area clean. Ask your child's pediatrician about strategies to prevent constipation and ways to keep your child from straining during bowel movements.
Lifestyle and home remedies
Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences:
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: 2010-08-31
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