What is an Anal Fissure?

Anal or rectal pain is one of the most common anorectal complaints and can be associated with rectal bleeding. Most frequently, the assumption is that the rectal bleeding is due to hemorrhoids; however, it is quite rare for hemorrhoids to cause pain. The most common cause is actually an anal fissure.

Fissure pain is commonly associated with hard bowel movements and can last from a few minutes to several hours. The association is so strong that many people will avoid having a bowel movement to escape the pain. This actually worsens the problem as delaying elimination of stool will make it even more dry and hard, exacerbating the fissure further. Because fissures are the result of a tear in the lining of the anal canal, slight bleeding is not uncommon. The diagnosis can usually be made from the history and a cursory evaluation to exclude other causes.

Treatment for Anal Fissures

Treatment for anal fissures involves addressing the cause of the hard stools. Frequently the addition of fiber supplements and fluids is sufficient to heal the fissure. Stool softeners and other topical adjuncts may also be added. Warm tub baths are generally helpful with pain relief. While the vast majority of fissures will heal with such simple approaches, chronic fissures that do not resolve after several weeks of conservative treatment may require surgical intervention. This requires relaxation of the anal muscles which in turn allows the fissure to heal.

Fissures do not cause colon cancer or increase the risk of developing cancer. However, if there is any concern for other associated problems further testing may be recommended.