Anal fissure

An anal fissure is a small, painful tear in the skin tissue that lines the opening of your bottom (anus).

By Wallace Health I Medically reviewed by Adrian Roberts.
Page last reviewed: October 2018 I Next review due: October 2021

What is an anal fissure?

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.

How to tell if you have an anal fissure

The main anal fissure symptoms are:

  • Sharp, burning pain during and after passing a stool
  • Bleeding after you’ve passed a stool (anal bleeding)
  • Itchy, irritated anus or anal pain 
  • A visible tear in the skin on your anus
  • A tag of skin on your anus (a sentinel pile)

Talk to your doctor if you’re concerned about symptoms

You can book an appointment with a Spire private GP today.

Diagnosis and tests for anal fissure

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.

Causes of anal fissure

There are different causes of anal fissure, including:

  • Constipation or diarrhoea
  • Pregnancy and childbirth – about one in 10 women develop an anal fissure after having a baby
  • Inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis
  • Taking certain medications, including some pain relief and some chemotherapy drugs
  • Anal sex
  • Certain cancers

Common treatments for anal fissure

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:

  • Ensure your diet contains lots of fibre, such as fruit, vegetables, wholemeal bread and cereals
  • Drink plenty of fluids, including water
  • Take regular exercise

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.

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