Anal Fissure

An anal fissure is a small tear in the skin around the back passage. It can become chronic if it lasts for more than 6 weeks. Basic ones are not usually serious but surely painful. However, some treatment is required to get rid of this condition.

  • Sharp pain and bleeding when you pass stools
  • Medication available to help reduce symptoms

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Anal Fissure

0 treatment(s) for Anal Fissure

DescriptionCausesTypes of treatmentQuestions and answers

An anal fissure is a small cut or a tear in the moist tissue (known as mucosa) that lines the anus. This small tear in the skin can cause mild to severe pain to those affected, and can even prompt bleeding during and subsequent to passing a bowel movement. Sometimes, the muscle tissue beneath the cut may become exposed which can lead to some seriously intense pain. People have also reported that they suffer from spasms in and around the anal sphincter (the muscle at the very end of your anus).

Anal fissures can develop in people of any age but are most prone to infants and young children. This is due to constipation being prevalent in these age groups. There are several symptoms which can be linked to anal fissures. Some include:

  • Burning, itching, or irritating sensation around the anus
  • A visible crack or tear in the skin that surrounds the anus
  • A small lump of the skin or a skin tap that appears next to the tear
  • Pain felt after a bowel movement that can last for up to several hours
  • Sharp pain in the anal region during bowel movements, sometimes very intense
  • Noticing blood in your excrement or on the toilet paper (following a bowel movement)

Anal fissures are typically harmless conditions which heal naturally after a period of around 4-6 weeks, on average. If it were to persist any longer than 8 weeks, it would then be considered as a chronic or long-term condition. If you are experiencing the symptom of blood in your stool or on toilet roll, it would be advised that you visit your doctor.

An anal fissure most typically develops subsequent to passing particularly hard or large stools. There are many potential causes for this condition. Some of them include:

Diarrhoea: A heavy bout of diarrhoea can be a definite way of an anal fissure developing. It has the potential to irritate the anus and form an ulcer.

Tight or spastic muscles: If the anal sphincter muscle happens to spasm, the risk of developing of an anal fissure is thought to increase greatly. A spasm is defined as a brief, jerking muscle movement, when the muscle can tighten suddenly. This can interfere with the natural healing process.

Pregnancy and childbirth: Pregnant women will have a much higher risk of developing anal fissure as the childbirth phase approaches. They also risk the lining of the anus tearing.

Underlying conditions: There are certain underlying conditions such as Crohn’s disease, ulcerative colitis, and other IBD’s that can sometimes be prone to causing the development of ulcers around the anal region.

In much rarer cases, STIs/STDs can be a cause for the initial development of anal fissure. Such infections that have been linked to this condition include herpes, HIV, HPV, tuberculosis, and syphilis. There are two muscular rings, known as sphincters, that control the anus. The outer ring can be consciously controlled, but the inner ring cannot. If the pressure of the inner sphincter gets too much it risks spasming, reducing the flow of blood, and increasing the risk of an anal fissure occurring.

The majority of cases of anal fissures often heal within a few weeks without the need to resort to extensive treatment. You can increase the speed of healing time and clear symptoms faster by taking necessary procedures to ensure no further irritation occurs. Such methods can include making sure that your excrement remains soft through methods like increasing the amount of fibre and fluids in your diet. Another means of achieving this is by soaking yourself in warm water for 10-20 minutes for every day you remain infected. This can be especially effective immediately after a bowel movement. However, if you continue to be plagued by the symptoms, some steps can be taken. These are:

  • Consume an increased amount of fluids
  • Take blood pressure medications such as diltiazem
  • Apply topical anaesthetic creams, such as lidocaine hydrochloride
  • Eat a more fibrous diet, consume more fruits and vegetables,
  • Apply nitroglycerin ointment or hydrocortisone cream (such as Q 10) directly to the anus

There are only 2 different forms of medicines which we stock to treat anal fissures. These are diltiazem, which is a blood pressure type medication that comes available as a 2% ointment, and rectogesic, which also comes available as a rectal ointment. If you have received over 2 weeks of treatment and your symptoms haven’t been relieved, you should seek further evaluation from a doctor/GP and make sure you have received the correct diagnosis initially.

If you are looking for some expert help, book an ONLINE consultation with our GMC Registered Clinicians at

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What different kind of anal fissures are there?

Anal fissures are very common amongst both adults and children and will generally pose no serious risks; a case like this would be referred to as acute. On the other hand, this condition can also cause great anguish and pain to certain people (mainly children), which would be referred as chronic.

What causes this condition to cause so much pain in chronic cases?

Pain levels vary from person to person and can occasionally be quite severe. The anal canal is one of the most sensitive areas of the human body, containing countless nerve endings.

Will my anal fissure bleed?

For some people, it can bleed as frequently as every time they sit the toilet, and will usually show up on toilet paper subsequent to wiping. It is one of the most sensitive areas of the human body, containing countless nerve endings.

How can I take care of myself daily?

It will generally be advised that you avoid symptoms by taking medicine like stool softeners and consuming lots of water. You should also ensure that you wash your anal region frequently and make sure it is as clean as possible at all times. Ways to achieve this include taking warm baths (known as sitz baths), and using wipes to keep the anal area as clean as possible. Over-the-counter medication can be resorted to, but only once recommended by a healthcare professional.

If you are looking for some expert help, book an ONLINE consultation with our GMC Registered Clinicians at

Patient discretion and confidentiality top the priority list at!