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Anal Fissure

Anal Fissure Facts

  • An anal fissure is a small tear in the skin overlying the anus that may occur when a hard stool is passed. Constipation is the most common cause of anal fissures.
  • Pain during the passage of a hard bowel movement, and sharp pain that continues afterward are the most common symptoms of an anal fissure. Sitting can be quite painful with an anal fissure.
  • A few drops of blood may be seen in the toilet bowel or when wiping. In an infant, there may be blood in the diaper.
  • The sphincter muscles that surround the anus and help prevent stool leakage may go into spasm and cause longer lasting pain with an anal fissure.
  • Diagnosis is made by history and inspection of the anus. No other tests are usually needed.
  • Treatment basics include drinking more fluid and eating a high fiber diet. Stool softeners, fiber supplements, and laxatives may be prescribed.
  • Surgery is considered only after diet and medications have failed.

Anal Fissure Causes

The anal canal is the last part of the colon or large intestine as it exits the body. It is very short, approximately 1-2 inches long and has two circular muscles that help control the passage of bowel movements. The internal anal sphincter is not a voluntary muscle, and it is always contracted to help prevent stool from leaking out. The external anal sphincter is a voluntary muscle.

  • An anal fissure describes a tear in the skin lining of the anal canal, or trauma to the anus and anal canal. The trauma usually occurs individual strains during a bowel movement or with constipation. Often, the individual may remember the exact bowel movement during which their pain began.
  • An acute anal fissure describes a tear in the superficial layer of skin.
  • A chronic anal fissure develops over time if the superficial tear does not heal. The tear extends deeper into the mucosa or tissue that lines the muscle of the internal anal sphincter.
Medically Reviewed by a Doctor on 2/18/2016
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Home Remedies for Anal Fissure

Most short-term (acute) and a few long-term (chronic) anal fissures will heal with home treatment.

  • Avoid constipation:
    • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
    • Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
    • Get some exercise every day. Try to do moderate activity at least 2? hours a week. Or try to do vigorous activity at least 1? hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.
    • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Start with a small dose and very slowly increase the dose over a month or more.
    • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
  • Stool softeners or laxatives can make bowel movements more comfortable. Ask your doctor how long you should take laxatives.
  • Sitting in a tub filled with a few inches of warm water (sitz bath) for 20 minutes 2 or 3 times a day soothes the torn tissue and helps relax the internal anal sphincter. This may help heal the anal fissure.

Healthwise. Anal Fissure.

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