An anal fissure is a small tear in the lining of the anus, and while it is minor, it can cause pain that feels anything but minor. Fissures are one of the most common causes of pain and bright red bleeding during bowel movements. The good news is that most heal with simple care at home. Here is what causes them and how to help them heal.
What an Anal Fissure Is
A fissure is a small crack or tear in the thin, sensitive tissue that lines the anal opening. It is often caused by passing a hard or large stool, which stretches the lining beyond what it can handle. Because the area has many nerve endings, even a small tear can hurt a lot.
Symptoms
- Sharp or burning pain during and after a bowel movement, sometimes lasting hours
- Bright red blood on the stool or toilet paper
- A visible small tear or skin tag near the anus
- Itching or discomfort in the area
What Causes Fissures
The most common cause is constipation and straining to pass hard stools. Other causes include diarrhea, childbirth, and less often, underlying conditions like inflammatory bowel disease. A tight anal muscle can also make fissures more likely and slower to heal.
How to Heal a Fissure at Home
Most fissures heal within a few weeks with steps that keep stools soft and ease the muscle:
- Add fiber and fluids so stools are soft and easy to pass. A high-fiber diet is the foundation.
- Take warm sitz baths, sitting in a few inches of warm water for 10 to 15 minutes a few times a day, which relaxes the muscle and eases pain.
- Do not delay bowel movements, and avoid straining.
- Use stool softeners if needed while it heals.
- Ask about creams that relax the muscle and improve blood flow to help healing.
When to See a Doctor
See a gastroenterologist if a fissure does not heal within a few weeks, keeps coming back, or the pain and bleeding are severe. Chronic fissures sometimes need a prescription cream, a small in-office treatment, or, rarely, a minor procedure to relax the muscle so it can heal. It is also important to make sure the bleeding is truly from a fissure and not another cause, which our guide on rectal bleeding explains.
Preventing Future Fissures
The best prevention is keeping stools soft and regular: plenty of fiber, enough water, regular activity, and not putting off the urge to go. These same habits protect against constipation and hemorrhoids too.
Talk to a Gastroenterologist in Mountainside, NJ
If your symptoms keep coming back or you are not sure what is causing them, Dr. Amber Khan can help. We see patients from across Union County and New Jersey.