All About Anal Fissure: Causes, Symptoms & Treatments


Contributed by: Priyaish Srivastava


What is an anal fissure?

An anal fissure originates from a small cut in the anal canal tissue from where the stool is excreted. It may be either acute or chronic anal fissure. An acute anal fissure may cure within a time period of 4 to 6 weeks, but if it takes longer than that, it might have turned into a chronic anal fissure that possibly requires surgery to cure. It is a common condition and may affect anyone of any age, while it is commonly confused with hemorrhoids due to the symptoms.


What causes an anal fissure?

The tissues present in the anal canal (mucosa) are soft and sensitive. The regular bowel movements sometimes get changed by the passing of large and hard poop that splits the skin around the anus and gives rise to a fissure.  This mostly affects people between the age of 15 to 40 years but can occur at any age even if you are above 40 years. 

Here are the top 3 causes of anal fissure:


  • Chronic constipation: It is one of the most common causes of anal fissure. Chronic constipation is a condition in which there may be 3 or less than 3 bowel movements in a week. This irregular bowel movement affects the anus and brings about strain to the skin present inside of the anal canal that results in anal fissure.


  • Diarrhea: Similar to chronic constipation, diarrhea is also one of the most common causes of an anal fissure. Diarrhea is an ailment in which the regular bowel movements become watery and loose. Diarrhea is a common condition that affects many individuals every year and may last for 2 to 3 days.


  • Childbirth: During childbirth, women might experience a severe condition of diarrhea where the anal tissues may stretch and contract frequently which may damage the tissue and cause an anal fissure


An anal fissure may also occur due to some rare conditions like anal cancer, sexually transmitted diseases (STDs), HIV, tuberculosis, leukemia, or inflammatory bowel diseases (IBD).


Symptoms of anal fissure:

An anal fissure is not a rare condition and may be identified by the following symptoms:


  • Pain during bowel movements
  • Constipation
  • Diarrhea
  • A crack or tear in the skin around the anus or anal canal
  • A lump near the place of tear
  • Blood in stool
  • Frequent burning or itching sensation in the anal canal
  • Pain in sitting or performing any physical activity
  • Discomfort while urinating
  • Foul smell discharge from the cut


Who are at risk for anal fissure?

An anal fissure is a common condition that can affect anyone but people who suffer from frequent constipation may be at an increased risk of getting it. Although it is common during one’s early years, senior citizens are also prone to anal fissure due to minimized movement of blood in their anorectal area. Women are prone to anal fissure mostly during and after the process of giving birth because of the great physical effort caused during pregnancy. 


Diagnosis of anal fissure:


A medical practitioner may usually diagnose the anal fissure without any complex procedure by simply examining the cut around the area of the anal canal by wearing surgery gloves. This procedure helps in determining the size and depth of the anal fissure.

Depending upon the seriousness of the anal fissure, the doctor may also conduct anoscopy. An anoscope (a thin tube with a tiny camera) is inserted inside the anus to get a clear and accurate image of the anal fissure. This procedure will also assist in determining any other cause of rectal pain and irritation such as hemorrhoids. 

If the condition of the anal fissure cannot be determined accurately even after anoscopy, the doctor might suggest going for an endoscopy to obtain more accurate and precise results.


Treatment of an anal fissure:

The anal fissure treatment aims to heal the crack in the anal canal to alleviate the pain and minimize discomfort and irritation. An acute anal fissure heals on its own within a timespan of a few weeks, but in the case of chronic anal fissure, it may be necessary to undergo anal fissure surgery. 

Selfcare required for anal fissure:


  • Drink plenty of water in a day to stay hydrated 
  • Increase the intake of fiber-rich foods like broccoli, beans, berries, whole grain, apple dry fruits, citrus fruits, and whole grains in the diet
  • Avoid caffeine and alcohol
  • Taking a warm water bath (also termed as a sitz bath) to increase the flow of blood in the anorectal area. This process relaxes and softens the anal muscles. 
  • Using over-the-counter (OTC) stool softeners and laxatives. But this should be consumed under the supervision of a doctor.
  • Applying ointments like nitroglycerine increases the blood flow in the anus muscles. It may also relax muscle irritation and inflammation.
  • Cleaning gently the anus area after every bowel movement
  • Prefer using medicated soaps for cleaning the anus area
  • Consult a doctor in case of chronic anal fissure


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