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Anal fissure: its treatment and causes

Anal fissure: its treatment and causes

Anal fissures are small cracks or tears in the anal mucosa that cause intense pain and light bleeding with bright red blood during or after defecation. The fissure may develop and deepen over time and may reach the submucosal muscle tissue.

Anal fissures usually do not pose any danger and may affect people of all ages, including newborns, children and teenagers, because constipation is common in this age group.

The fissure usually heals on its own within 4-6 weeks, but if it continues for more than 8 weeks, it becomes a chronic injury. There are many effective treatments that can relieve the uncomfortable symptoms of an anal fissure, 

such as laxatives and topical pain relievers, and when previous treatment fails, surgery is the best treatment option. Sometimes a fissure is a symptom of underlying anal and rectal disease and needs investigation.


An anal fissure may cause one or more of the following symptoms:

  • There are visible cracks in the skin covering the anus.
  • Chronic inflammatory diseases of the intestine, such as Crohn's disease.
  • Anorectal ischemia.
  • Narrowing or spasm of the anal sphincter.

The following conditions rarely cause anal fissures:

  • Anal cancer.
  • AIDS virus.
  • Syphilis.
  • Herpes disease.

Who gets infected

Anal fissures occur at all ages, but are most common in:

  • children.
  • Women due to excessive stress and tension during or after childbirth.
  • Patients with chronic inflammatory bowel disease, because the inflammation damages the anal mucosa and facilitates its rupture.
  • Often people with constipation, the straining and pressure of having a bowel movement, and passing hard stools that can damage the anal mucosa.

Anal fissure: its treatment and causes

The diagnosis

Diagnosing an anal fissure is based only on examining the area around the anus and looking at the fissures. Sometimes a doctor examines the anus through a proctoscope to confirm the diagnosis with an anoscope.

An endoscope is a thin tube that can enter the anal canal and see the fissure. This endoscopy can help the doctor find other causes of pain, such as hemorrhoids, and can use an endoscopy to evaluate symptoms.


Most anal fissures do not require extensive treatment. Simple home remedies can aid recovery and relieve symptoms, including:

  • Laxative use.
  • Drink more water.
  • Increase your intake of foods that contain fiber, such as fruits and vegetables, and take fiber supplements.
  • Sitting in a warm soak relaxes the anal muscles, reduces irritation and increases perfusion in the anal area.
  • Use an ointment containing nitroglycerin to widen blood vessels and increase blood flow to the anus, or use hydrocortisone ointment to treat inflammation.

If your symptoms do not improve within two weeks of treatment, you should consult your doctor. He or she may adopt more effective treatments, such as using ointments containing calcium channel blockers, which can relax the anal sphincter muscle and help the anal fissure heal.

Injections of Botox into the anal sphincter can also have antispasmodic effects, causing temporary paralysis in the anal sphincter, which helps to heal and prevent new fissures in the area.

If you are concerned about a wound problem that is difficult to solve with home remedies, you should ask your doctor for further investigations and tests.

Preventing anal fissures

Anal fissures cannot be completely prevented, but we can take a series of preventive measures to reduce the risk of anal fissures, including:

  • Keep the anus dry.
  • Gently clean the anal area with warm water and a non-irritating soap.
  • Drink plenty of water, eat more fiber-rich vegetables and fruits, and go to the toilet to have a bowel movement regularly to avoid constipation.
  • Treat diarrhea promptly.
  • Change baby diapers frequently.


An anal fissure is an acute injury that can cause severe pain and slight bleeding during a bowel movement. You may have frequent infections that can become chronic infections that lead to protrusion of the anal skin.

In addition to sexually transmitted diseases, several diseases may also cause anal fissures, such as previous anal surgery, inflammatory bowel disease and local anal cancer. One of the most important direct causes.

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