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What are anal fissures?

An anal fissure is a small crack or tear in the thin, moist lining of the lower rectum. It is a common condition. Sometimes people confuse anal fissures with hemorrhoids.

Symptoms of anal fissures

The most common symptom of an anal fissure is a shooting pain in the anus and surrounding area. Anal fissures often cause painful bowel movements and bleeding. You may also see blood on the toilet paper after wiping. Anal fissures may also cause itching in the anal area.

What causes anal fissures?

Anal fissures are usually a result of straining during a bowel movement, causing injury to the anal canal. They also can be caused by repeated diarrhea, when blood flow to the area is decreased (in older adults), after childbirth, or in people with Crohn’s disease.

How are anal fissures diagnosed?

Your healthcare provider may perform a rectal exam. Usually, a visual exam is all that’s necessary to see the fissure. Your healthcare provider might have to insert a lubricated, gloved finger into the anal canal.

Can anal fissures be prevented or avoided?

Keeping bowel movements regular and avoiding constipation can help reduce your chances of an anal fissure. Add more fruits, vegetables, and whole grains to your daily plate to get enough fibre. Drink plenty of fluids and get some exercise in every day to help keep your digestive system moving.

Living with anal fissures

Your healthcare provider may recommend stool softeners to make going to the bathroom easier and less painful while the fissure heals. Numbing cream can also make bowel movements less painful. Petroleum jelly, zinc oxide, 1% hydrocortisone cream can help soothe the area. Instead of toilet paper, use alcohol-free baby wipes that are gentler on the area.

Sitz baths can help heal fissures and make you feel better. Fill the tub with enough lukewarm water to cover your hips and buttocks. Don’t use soap or bubbles or any other products unless recommended by your healthcare provider. Relax in the sitz bath 2 to 3 times a day for about 10 minutes at a time.

People who develop fissures once are more likely to have them in the future, so it’s important to keep bowel movements regular. If you’re worried about pain during a bowel movement, you might be tempted to hold it in. But that will only cause the stools to become harder, making the fissure worse. Continue with a high-fibre diet and plenty of liquids.