Anal fissure

Overview

An anal fissure is a lengthwise tear in the lining of the anus. Possible causes of an anal fissure include hard stools, prolonged constipation and bowel diseases. Pain during bowel movements and bright red blood on the toilet paper are typical. Preventive measures include good post-defecation hygiene and a high-fibre diet.

Symptoms

Main symptoms

• Lengthwise superficial tear near the anus
• Severe burning, searing and cramping pain (particularly during bowel movements)
• Cramping of the sphincter muscle (bowel movement requires strong pressing)
• Bleeding (bright red blood in stool or on the toilet paper)

Complications

• A chronic anal fissure can lead to an anal fistula or anal abscess

Causes and treatment

Causes

• Hard stools
• Haemorrhoids
• Persistent diarrhoea or constipation
• Bowel diseases (e.g. Crohn’s disease, ulcerative colitis, anal cancer)

Further treatment by your doctor / in hospital

Possible tests

• An anal fissure is easy to see; further tests are not usually needed

Possible therapies

• Painkillers
• Anti-inflammatory ointments
• Sitz baths
• Operation (rarely)

What can I do myself?

• Good post-defecation hygiene (e.g. using wet wipes)
• Stimulate bowel movements
  • High-fibre diet with lots of vegetables, salads and fruit
  • Drink plenty of fluids
  • Sufficient exercise

When to see a doctor?

• No improvement in spite of careful hygiene and better bowel movements
• Pain causes constipation

Synonyms

Anal fissure