Anal fissure

Anal fissure is a small tear in the skin lining of the anus. Childbirth, straining during defecation or frequent bouts of constipation and diarrhea can all cause a tear in the anal mucosa.

Usually these tears are nothing to worry about and most often heal without any medical treatment.

However, if they do not disappear for a long time and do not respond to conservative treatment, surgery may be necessary.

What are the symptoms?

• A visible tear in the skin surface of the anus;
• A small lump of skin in close proximity to the tear;
• Severe pain in the anal area when defecating ;
• Reddish streaks resembling blood in the stool or bloody toilet paper when wiping;
• Burning or itching in the anal area;

What are the causes?

The skin around the anus can be torn when large and hard stools are passed.

Chronic constipation or diarrhea is often the cause of such ruptures.

Other possible causes are:

• Crohn’s disease or other disease of the irritable colon;
• Straining of the muscles of the anus during childbirth;
• Decreased blood flow to the anorectal area due to advancing age;
• Excessively tight or spastic muscles of the anal sphincter.

Treatment of anal fissure

The doctor can make a diagnosis with only a visual examination. But sometimes it is necessary to insert an endoscope or anoscope into the rectum to be able to examine -well the tear.

In most cases, anal fissures can be treated at home, for example you can add foods containing fiber to your daily menu or use stool softeners.

Also warm baths will help to relax irritated chapped skin and increase blood flow to the anal area. To relieve the discomfort, you can also use ointments that will moisturize the injured skin and speed up its healing.

Topical anal pain relievers such as lidocaine will help relieve pain.

Your doctor may also recommend calcium channel blockers in the form of an ointment, which will relax the sphincter muscles, allowing the anal tear to heal.

He can also use nitroglycerin cream, which is available without a prescription in pharmacies and applied anally, it dilates the blood vessels, which increases blood flow to the anus and promotes healing of the tear.

Another method of treatment is with Botox injections administered in the anal sphincter. This method prevents spasms in the muscles of the anus by temporarily paralyzing them.

The goal is to allow the fissure to heal and prevent new tears from forming.

But if the tear doesn’t respond to conservative treatment methods and partially invasive Botox injections, your doctor may recommend an anal sphincterotomy.

This is a surgical procedure in which a small incision is made in the anal sphincter, with the goal of temporarily relaxing its muscle, which will allow the tear to heal.


Although anal fissures cannot always be prevented, you can reduce the risk of their occurrence by:

• Clean your anal area carefully;
• Prevent constipation by drinking plenty of fluids, eating foods containing fiber and exercising regularly.
• Treat diarrhea immediately;
• Keep your anal area dry;
• To prevent anal fissures in infants, change their diapers or diapers frequently;

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