An anal fissure is a small tear in the thin, moist layer of tissue that lines the anus.

It may develop when someone passes a hard or large stool during a bowel movement. Signs and symptoms of anal fissure can be alarming, as the condition can cause pain and bleeding. Some people are at higher risk for developing anal fissures. Fortunately, anal fissures may be preventable and a number of treatments are available.

Symptoms Anal Fissure

Anal fissures will typically cause bleeding and pain during bowel movements. Spasms in the ring of muscles surrounding the anal sphincter at the end of the anus may also occur.

Signs and symptoms of anal fissure include:

  • Pain during bowel movements – pain may be severe
  • Pain that continues after bowel movements, sometimes for several hours
  • The presence of bright red blood on the stool or toilet paper following a bowel movement
  • A visible tear or crack in the skin around the anus
  • A skin tag or small lump situated near the anal fissure

Risk Factors for Anal Fissures

Certain factors can increase someone’s risk for developing anal fissures. These risk factors include:

  • Constipation – passing hard stools and straining during bowel movements can increase the risk that the tissue around the anus will crack or tear
  • Childbirth – anal fissures are more common in women after they have given birth
  • Crohn’s disease – because it causes chronic inflammation of the intestinal tract, this inflammatory bowel disease can make the lining of the anal canal more vulnerable to tearing
  • Anal intercourse
  • Age – while anal fissures can develop at any age, they are more common in infants and in middle-aged adults

Diagnosis and Treatment of Anal Fissures

Diagnosis always starts with a thorough review of the patient’s symptoms and medical history, and a gentle exam of the anal region. The tear is often visible, which makes it easy to diagnose. An acute fissure looks somewhat like a paper cut or fresh tear, whereas a chronic fissure often has a deeper tear and it may have internal or external fleshy growths.

Doctors may recommend further testing if they think an underlying condition caused the anal fissure. These tests include:

  • Anoscopy – a tubular device that helps the doctor visualize the anus and rectum
  • Flexible sigmoidoscopy – a thin, flexible tube with a tiny camera inserted into the colon
  • Colonoscopy – a flexible tube that allows the doctor to inspect the colon

Treatment depends largely on the severity of the anal fissure. In many cases, an anal fissure will heal on its own, especially if the patient keeps stool soft by increasing their intake of fluid and fiber. Soaking in warm water for a few minutes can help too. Anal fissures that do not heal on their own may require treatment with medication or surgery.

If you are experiencing symptoms of anal fissure, contact Allied Digestive Disease Center of Houston. Our gastroenterologists in Houston offer complete care for anal fissure, from diagnosis to treatment. Make an appointment today by calling 832.981.2087.


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