1. Constipation Myths and Facts Slideshow
2. Hemorrhoids Slideshow: Causes, Symptoms, and Treatment
3. Hemorrhoids Quiz: Test Your Medical IQ of Piles

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

View Full Profile

Medical Editor:

Bhupinder Anand, MD

The diagnosis of anal fissure is most commonly made after the health care practitioner takes a history of the patient's complaint and performs a physical examination. The history of constipation followed by a painful bowel movement and rectal pain that continues afterwards is often enough to make the preliminary diagnosis.

Physical examination is usually limited to inspection of the anus, looking for the crack or tear in the skin surrounding the anus. Because of the amount of pain and discomfort, the rectal examination, where a finger is inserted into the rectum to feel for abnormalities and to check for blood in the stool, is usually deferred.

If the fissure is not seen and there is doubt about the diagnosis, a flexible sigmoidoscopy may be considered, where the health care practitioner inserts a short lighted tube into the anus to inspect the area. Usually, lidocaine ointment is used as an anesthetic to make the procedure less uncomfortable.

No other blood tests or X-rays are needed.

Anal fissures that are due to constipation usually are found in the midline. If the fissure is located off to the side, other underlying medical conditions may be the cause, including Crohn's disease (a type of inflammatory bowel disease), HIV infection, and cancer.

Must Read Articles Related to Anal Fissure

Constipation in Adults Constipation in adults refers to difficulty in passing stools or a decrease in the frequency of bowel movements. Causes of constipation in adults include a poor...learn more >>

Constipation in Children Constipation in children affects up to 10% of children at any given time. Causes of constipation in infants and children include a willfulness to avoid the toil...learn more >>

Diarrhea Diarrhea can be caused by bacterial or viral infections, parasites, intestinal diseases or conditions, reactions to medications, and food intolerance. Symptoms ...learn more >>

See the Entire Anal Fissure Topic Guide »