Overview
An anal fissure is a small tear in the thin, moist tissue lining the anal canal. It is one of the most common causes of painful bowel movements and rectal bleeding. Most fissures are caused by trauma from hard or large stools. Acute fissures usually heal within a few weeks; chronic fissures (lasting more than 8 weeks) require medical treatment.
Symptoms
Sharp pain during and after bowel movements
Bright red blood on toilet paper or in the toilet
A visible crack or tear near the anus
Burning or itching after bowel movements
A small skin tag at the edge of the fissure (chronic)
Common Causes
Hard or large stools (most common)
Chronic diarrhea
Constipation and straining
Vaginal childbirth
Anal intercourse
Inflammatory bowel disease (Crohn's)
Self-Care Tips
Increase fiber and fluid intake to soften stools
Soak in a warm sitz bath for 10–20 minutes after each bowel movement
Apply topical nitroglycerin or calcium channel blockers as prescribed
Use stool softeners if constipated
Avoid straining — never force a bowel movement
Surgical sphincterotomy may be needed for chronic fissures not responding to treatment
When to See a Doctor
See a doctor if pain is severe, bleeding is heavy, symptoms haven't improved after 4–6 weeks of home care, or if you have any concern about hemorrhoids or colorectal disease. Do not assume all rectal bleeding is a fissure.
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