What Is an Anal Fissure?

An anal fissure is a small tear in the thin tissue around the opening of the anus. It can happen when the area stretches too much, often during a hard bowel movement. The tear may cause pain, irritation, and bleeding.

Anal fissures are common and can affect people of any age. While symptoms can feel similar to hemorrhoids, the two conditions are different and may require different treatment approaches.

Several factors can increase the risk of developing an anal fissure, including:

• Constipation or hard stools
• Frequent straining
• Ongoing diarrhea
• Low-fiber diet
• Childbirth
• Injury or trauma to the area
• Conditions such as Crohn’s disease

Symptoms

Anal fissures often develop after strain or irritation to the anal area. Symptoms may range from mild discomfort to significant pain during bowel movements.

Common symptoms include:

• Sharp pain during bowel movements
• Burning or aching afterward
• Bright red blood on toilet paper or stool
• A visible crack or tear near the anus
• Irritation or itching around the area

How Is It Diagnosed?

A healthcare provider can often diagnose an anal fissure during a physical exam. They’ll ask about your symptoms, bowel habits, and medical history before carefully examining the area.

In some cases, additional testing may be recommended to rule out other digestive conditions or causes of bleeding. This could include a rectal exam or procedures such as a colonoscopy.

How Is It Treated?

Many anal fissures heal with simple, nonsurgical treatment. The first goal is usually to reduce pain and make bowel movements easier.

Treatment may include:

• Eating more fiber-rich foods
• Drinking plenty of water
• Using stool softeners or fiber supplements
• Taking warm sitz baths
• Applying prescription creams to relax the anal muscles and support healing

If symptoms continue or the fissure becomes chronic, more advanced treatment may be needed. Some patients benefit from botulinum toxin injections or a minor surgical procedure to reduce muscle tension and improve healing.

Most acute fissures improve within a few weeks when treated early. Preventing constipation can help lower the chance of the fissure returning.