Medically reviewed by Meghan Maynard Harlan. Last updated on February 27, 2025
General Illness Information
Common Name:
ANAL FISSURE
Medical Term: Fissure-in-Ano
Description: A tear or ulcer in the lining of the anus, causing pain on defecation.
Causes: Causes include stretching of the anal wall by large hard stool or tightening of the anal canal due to tension or the laceration by foreign body.
Prevention:
Avoid constipation by:
- Drinking at least 8 glasses of water daily;
- Eating a diet high in fiber;
- Using stool softeners if needed;
- Don’t strain at stool;
- Avoid anal intercourse.
Signs & Symptoms
- Painful bowel movement associated with bright red bleeding.
- Pain then subsides and recurs with the next bowel movement.
- Streaks of blood on toilet paper, underwear or diaper.
- May become chronic, with periods of exacerbation or remission
- Fissure causes the sphincter to go into a spasm, which may prevent healing.
Risk Factors
- Constipation
- Multiple pregnancies
- Leukemia
- Crohn’s disease
- Immunodeficiency disorders
- Chronic use of laxatives
Diagnosis & Treatment
General Measures:
- Examination of the anus and rectum with an anoscope or sigmoidoscope to rule out other causes of anal or rectal bleeding.
- Gently clean the anal area with soap and water after each bowl movement
- To relieve muscle spasms and pain around the anus, apply a warm towel to the area
- Sitz baths also relieve pain. Use 8 inches of warm water in the bathtub, 2 or 3 times a day for 10 to 20 minutes.
- Surgery may be necessary, if conservative treatment is not successful, to remove the fissure or to alter the muscle that contracts and prevents normal healing
Medications:
- For minor pain, use non-prescription drugs, such as acetaminophen or topical anesthetics.
- Zinc oxide ointment or petroleum jelly applied to the anal opening may help to prevent the burning sensation.
- Bulk stool softeners will help to avoid the pain occurring with bowel movements.
- Lidocaine ointment may be recommended.
Activity:
No restrictions. Physical activity reduces the likelihood of constipation.
Diet:
A high-fiber diet and extra fluids (ie. 8 glasses of water a day) to prevent constipation are recommended.
Possible Complications :
Permanent scarring that prevents normal bowel movements.
Prognosis
Most adults recover in 4 to 6 weeks with treatment, making surgery unnecessary. Most infants and young children recover after the stool is softened.
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