Anal Fissures: Causes, Symptoms and Treatment
An anal fissure is a small tear in the lining of the anal canal. It typically causes sharp pain during and after bowel movements, and sometimes a little bright red blood. Fissures are common at any age and usually respond well to treatment.
What is an anal fissure?
Fissures are often caused by passing a hard stool or by straining, and sometimes by diarrhea or childbirth. The tear can make the surrounding muscle (the anal sphincter) go into spasm, which reduces blood flow and stops the fissure from healing. A fissure that heals within a few weeks is called acute. One that lasts longer than six to eight weeks is called chronic.
Common symptoms include:
- Sharp or burning pain during a bowel movement
- Aching that can last for hours afterwards
- Bright red blood on the toilet paper
- A small lump or skin tag near the tear
Treatment Options
1. Softening the stool and relaxing the muscle
Most acute fissures heal with more fibre and water, stool softeners, warm baths and a prescription ointment that relaxes the sphincter.
2. Botulinum toxin injection
For fissures that do not heal with ointment, doctors use botulinum toxin injection as a treatment. The injection is done in the clinic.
3. Surgery
Chronic fissures that do not respond to other treatment may need a short operation, such as a lateral internal sphincterotomy (a small cut in part of the sphincter muscle to relieve the spasm) or a fissurectomy (removal of the fissure edges). These are performed in state-of-the-art operating rooms located near the Center. Your doctor will explain the benefits and possible risks of each option.
After Treatment
Keeping stools soft remains important while the fissure heals. Your doctor will give you written instructions and arrange follow-up.
When to Seek Medical Care After Botulinum Toxin Injection or Fissure Surgery
Contact your doctor if you experience:
- Heavy bleeding
- Fever or increasing pain
- Signs of infection, such as swelling or discharge
Anal fissures are painful but very treatable. A consultation confirms the diagnosis and gives you a clear plan, starting with the simplest effective option.
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