Anal fissure 



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

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

The most common symptoms of anal fissures include:

  • a sharp pain or burning sensation when passing a stool (poo)
  • noticing bright red blood on toilet paper or on the toilet seat

Read more about how anal fissures are diagnosed.

The anal canal

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

The anal canal is approximately 2.5-4cm (1-1.5in) long in adults and is lined by a thin layer of cells known as squamous epithelium cells. If this lining becomes damaged, an anal fissure can develop.

Causes of anal fissures

Most anal fissures occur when passing particularly hard stools (constipation) which can damage the anal canal.

Other known causes include:

Read more about the causes of anal fissures.

Anal fissures can also be classified according to how long symptoms last. For example:

  • acute anal fissure – where symptoms do not last longer than six weeks
  • chronic anal fissure – where symptoms last longer than six weeks

Treating anal fissures

Anal fissures usually heal within a few weeks without the need for medical treatment. Switching to a high-fibre diet should also help to relieve symptoms and speed up the recovery time because the fibre makes it easier to pass stools.

Treatment for chronic anal fissures can vary from person to person. Some cases can be relieved by switching to a high-fibre diet, whereas others may need medication or even surgery.

Read more about how anal fissures are treated.

It is not always possible to prevent anal fissures, but you can take steps to prevent constipation, which is a common cause. This includes eating a healthy diet with plenty of fibre and drinking regular fluids.

Read more about preventing anal fissures.

Who is affected

Acute anal fissures are relatively common. They affect both sexes equally and occur in people of all ages, including children. However, younger adults between the ages of 20 to 40 are most likely to develop one.

Chronic anal fissures are less common than acute anal fissures, but they are certainly not rare. It is estimated that around 10% of people who visit a proctologist (a doctor who specialises in conditions that affect the rectum and anus) do so because they have a chronic anal fissure. 

Page last reviewed: 23/05/2012

Next review due: 23/05/2014


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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

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

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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.

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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.

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