Anal fissure 

Introduction 

Constipation

Eating fibre, drinking enough fluid and regular exercise can help you get over constipation. In this video, an expert explains how you can help yourself and when you should see your GP.

Media last reviewed: 21/02/2013

Next review due: 21/02/2015

Digestive health

Find out how to beat common digestive problems like bloating and indigestion

An anal fissure is a tear or ulcer (open sore) that develops in the lining of the anal canal.

The anal canal is the last part of your large intestine, and is located between your rectum (a reservoir where stools are stored) and your anal orifice (the opening through which stools are passed out of the body).

Signs and symptoms

The most common symptoms of anal fissures are:

  • a sharp pain when you pass stools (faeces), often followed by a deep burning pain that may last several hours
  • bleeding when you pass stools  most people notice a small amount of bright red blood either in their stools or on the toilet paper

When to see your GP

Visit your GP if you think you have an anal fissure.

Don't let embarrassment stop you seeking help. Anal fissures are a common problem that GPs are used to dealing with.

Most anal fissures get better without treatment, but your GP will want to rule out other conditions with similar symptoms, such as haemorrhoids (swellings in or around the rectum and anus). They can also advise you about self-help measures and treatments that can help relieve your symptoms and reduce the risk of fissures recurring.

Diagnosing anal fissures

Your GP will first ask about your symptoms and the type of pain you have been experiencing. They may also ask about your toilet habits.

Your GP will usually be able to see the fissure by gently parting your buttocks.

digital rectal examination (where your GP inserts a lubricated, gloved finger into your anus to feel for abnormalities) is not normally used to diagnose anal fissures, because it is likely to be painful.

Your GP may refer you to a specialist for assessment if they think something serious may be causing your fissure. This may include a more thorough examination of your anus, carried out using anaesthetic to minimise pain. 

The measurement of a person's anal sphincter (the ring of muscles that open and close the anus) pressure is occasionally used for fissures that have not responded to simple treatments.

What causes anal fissures?

Anal fissures are most commonly caused by damage to the lining of the anus or anal canal. Most cases occur in people who have constipation, when a particularly hard or large stool tears the lining of the anal canal.

Other possible causes of anal fissures include:

In many cases, no clear cause can be identified.

Who is affected

Anal fissures are relatively common, with an estimated 1 in every 10 people affected at some point in their life.

Anal fissures affect both sexes equally and occur in people of all ages, including very young children. However, most cases occur in children and young adults between the ages of 10 and 30.

Treating and preventing anal fissures

Anal fissures usually heal within a few weeks without the need for medical treatment, although they can easily recur if they are caused by constipation and this remains untreated. In some people, symptoms from anal fissures last six weeks or more (chronic anal fissures).

It can be helpful to adopt some simple self-help measures to help make it easier to pass stools, which can allow existing fissures to heal and reduce your chances of developing fissures in the future. These measures include:

  • making sure you have plenty of fibre in your diet
  • staying well hydrated by drinking plenty of fluids
  • not ignoring the urge to pass stools
  • exercising regularly

Your GP can also prescribe medication to help relieve your symptoms and help speed up the healing process. This can include laxatives to help you pass stools more easily and painkilling ointment that you apply directly to your anus.

In persistent cases where self-help measures and medication have not helped, surgery may be recommended. Surgery is often very effective in treating anal fissures, but it does carry a small risk of complications, such as temporary or permanent loss of bowel control (bowel incontinence).

Read more about treating anal fissures and preventing anal fissures.

Page last reviewed: 06/05/2014

Next review due: 06/05/2016

Ratings

How helpful is this page?

Average rating

Based on 313 ratings

All ratings

Add your rating

Comments

The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

healthy1973 said on 15 July 2014

I have completely cured my anal fissure by moving onto a plant based diet filled with lots of veg, salad and fruits. Drinking lots of water also (keep a big bottle with you all day). Bowel movements need to be speedy and soft! I am now totally healed after two very painful, uncomfortable months. Please believe me that body can heal itself if you eat the right stuff (green leafy veggies and plant proteins). If you are in chronic pain I suggest a vegetable juice fast as this really helped me get kick-started on the healing. It has really been god sent as I am now working towards a healthy vegan diet with no animal protein or refined white carbs. I feel absolutely brilliant. What are you waiting for!

Report this content as offensive or unsuitable

Guitarman7 said on 21 October 2013

I have chronic Anal fissure and have had for over 3 yrs. I have been prescribed and tried everything on the market to no avail.
In March 2013 I underwent 'Botox' injections and was told to give it 3 months for allow for the healing process.
Today, October 2013 have just undergone the same process needless to say the first attempt didn't work I only hope that this one does, otherwise, it's more invasive( but a simple) procedure with a 1-20 chance of minor incontinence.
What I would like to say is, if you think you have the slightest suspicion you have this condition then consult your doctor immediately, don't suffer 3 years of total misery as I have, just because I was a tough guy and too embarrassed to see a doctor

Report this content as offensive or unsuitable

davecb said on 14 February 2013

It might be worth noting that maybe more than 10% of people have this but many don't go to the doctor. I know i certainly didn't want to go. Having someone pull apart my anus and insert a finger was definitely not pleasant and her lack of humour when i asked her to be careful because it was my 1st time certainly didnt help matters , but i recommend going if you have any of the symptoms. It will only get worse if it doesn't heal on its own and although it might seem embarrassing its something that needs to be done.I got prescribed Anusol. Its a cream you have to insert into your anus. Although putting the tube into your anus doesnt hurt it isnt pleasant either. You do not feel the cream. My biggest problem is i dont apply the cream 3 times a day like you should. So its my own fault mine isnt gone , but there is near instant relief from the cream and swapping all your means for high fiber food definately helps as you go to the toilet less and when you do you pass the stool easy. I havent tried coconut oil but will definately consider it. Another thing to watch out for is hemorrhoids? if i spelt that right.If like me you go and it hurts and you push harder to get the pain over with you may get hemorrhoids as i did, so i definately reccomend keeping up with the treatment and getting on with it. I just hope you get a better doctor or nurse than the one i did. I know it isnt pleasant having to look between my butt cheeks but there are worse jobs out there.

Report this content as offensive or unsuitable

SLISK said on 28 November 2012

I am only 20 years old and I've had a chronic anal fissure for 5 years, there have been times where I literally cannot sit down, sleep and would break down crying. In the last few months I have been looking at auyverdic diet and healing. I come across using coconut oil directly on the rectum! I have never felt so good and it has changed everything I've been using it for a week and already the impact has been huge. After years of trying everything people need to know about this! I hope this helps someone.

Report this content as offensive or unsuitable

Rectal bleeding

What to do if you are bleeding from the bottom, and the common causes

Eat right for your digestion

How to eat and drink to ensure a good digestion, including foods to avoid and which ones to fill up on.