Anal Fissure

An anal fissure is a tear in the skin of the anus. Fissures can be acute or chronic.

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Anal fissures are usually associated with constipation, as it typically occurs when you pass hard stools or large stools during a bowel movement. Frequent passage of stools such as during a bout of diarrhoea may also cause an anal fissure.


The most dramatic thing about anal fissure is the pain. The pain is usually intense and severe. It is often described as a burning or searing pain. Patients usually remember the exact bowel movement when their pain began. The pain after bowel movements can even last for a few hours. There may also be bright red blood seen. Some people can feel a lump near the anus – this is called a sentinel pile.


Most acute anal fissures will usually heal on their own, or only require simple treatment. Some may need medications, and occasionally surgery. If the fissure persists beyond 6 weeks, it is called a chronic fissure. These are sometimes associated with inflammatory bowel disease. Anal fissures are also believed to be associated with an increased tightness of the anal sphincter muscles.

Seeking a medical consult

You should consult a doctor when you experience pain during bowel movements or if you see blood on the stools or the toilet paper. The doctor can confirm the diagnosis by a careful examination of the anus.


The initial treatment of an anal fissure involves pain relief, and medication to relieve constipation, or stop diarrhoea. Other simple treatment includes increasing your intake of fibre, stool softeners and Sitz bath.Topical ointments such as Rectogesic gel can be used to relax the tight muscle tone of the anus.


If the above measures fail, surgery may be performed, in which a small cut is made to the anal muscles to release the tight muscles. The name of this operation is called Lateral Sphincteromy.


Anal fissures may be prevented by taking measures to prevent constipation. Take a well-balanced diet with a generous dose of fibre like vegetables and fruits. Keep yourself well hydrated and exercise regularly.

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