An anal fissure occurs when the area around the anus is stretched and the skin tissue tears. This damage is often the result of passing hard or large stools and can cause pain and bleeding.
Anal fissures are a common complaint that can happen at any age. They’re more likely between the ages of 15 and 40. Pregnancy and childbirth can increase the risk of anal fissures.
In most cases, anal fissures aren’t serious and heal quickly, without the need for treatment. If you’ve any concerns, or an anal fissure hasn’t healed after six weeks (a chronic anal fissure), see your GP.
The main anal fissure symptoms are:
Your GP will confirm if you have an anal fissure or a condition with similar symptoms, such as piles (haemorrhoids) or bowel polyps.
They’ll ask about your anal fissure symptoms, including anal fissure pain, your bowel habits and your general health. Your GP will also examine your anus.
Your GP may refer you to a consultant for further investigations. These investigations might include an examination of the inside of your rectum (proctoscopy) and/or an ultrasound scan.
There are different causes of anal fissure, including:
Anal fissures often heal on their own. To relieve anal fissure pain, try taking over-the-counter pain relief such as ibuprofen and paracetamol. You might also find it helps to sit in a warm bath after passing stools.
Constipation and passing hard or large stools can prevent an anal fissure from healing and can also trigger a recurrence. To reduce the risk of constipation and straining excessively when passing a stool, you should:
If your anal fissure isn’t healing, your GP may prescribe laxatives or medication to relax the muscles in your anus. They may also prescribe anal fissure cream, a local anaesthetic to block the pain from your anus.
If you regularly have anal fissures, your GP or consultant may recommend surgery. There are a number of surgical procedures that can successfully treat anal fissures. Your doctor will discuss your options with you.