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Anal Fissure Symptoms, Causes, Diet, and Treatments

Facts and Definition of Anal Fissure

  • 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.

What Causes Anal Fissures?

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.

What If My Baby Has An Anal Fissure?

Anal fissures routinely occur in infants, and are the most common reason for the presence of blood in the diaper. The most frequent cause is the passage of a hard bowel movement. The infant may grunt or cry when trying to pass the hard stool and drops of blood may be seen on the diaper. Blood is not mixed in with the stool.

It is important not to ignore blood in an infant's bowel movement or diaper because an anal fissure may not be the cause. It is reasonable and appropriate to contact a health care practitioner to arrange a visit.

If constipation is the cause of the anal fissure, adding corn syrup to the formula may be helpful. If the infant is older than 3-4 months, some fruit juice may also help with the bowel movement. The health care practitioner is a good resource for information.

Medically Reviewed by a Doctor on 9/11/2017
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