When Your IBS Causes Anal Fissures

Table of Contents
View All
Table of Contents

Anal fissures are a common complaint of people who have IBS, particularly those who have constipation-predominant IBS. The hard stools and straining associated with constipation are both possible contributors to the onset of anal fissures. The silver lining here is that anything you do to help your system to treat your IBS and get your system to function more regularly should also help to reduce your risk of a fissure.

Anal fissure treatments
Verywell / Brianna Gilmartin

What Are Anal Fissures?

Anal fissures are small tears in the lining of the opening of the anus. Anal fissures can be quite painful, particularly during a bowel movement. You may see signs of bleeding, either on the stool, on your toilet paper, or in the toilet.

Note: Any sign of blood associated with your bowel movements needs to be brought to the attention of your healthcare provider as it can be the sign of a serious health problem.


The main recommendation for avoiding fissures is to keep your stool soft. Although this can be difficult to do with IBS, there are a couple of things that you can try:

  • Increase your fiber intake. Do this slowly as to allow your body time to adjust without exacerbating your symptoms.
  • Stay well hydrated so as to help to keep your stools soft.
  • Try not to strain during your bowel movements. Stay relaxed and let the process happen on its own.
  • Don't delay your bowel movements. Respect any urges from your body to eliminate and head for a bathroom. While you may not want to use the restroom at work or public restrooms while out of the house, don't hold it in until you get home.
  • Try using bowel retraining strategies as a way to try to establish a more regular schedule for bowel movements, thus encouraging more frequent, and therefore softer, stools.
  • Talk to your healthcare provider about medication to keep your stools soft, such as Metamucil (psyllium) or Miralax (polyethylene glycol 3350)

What to Do When You Have an Anal Fissure

  1. Take a sitz bath, particularly after experiencing a bowel movement. This is an easy home treatment of sitting in warm water for 15 to 20 minutes. Sitz baths encourage the movement of blood in the area of your anus, which helps to promote healing. You can find a sitz bath bowl that fits onto a toilet for convenience.
  2. After bowel movements, clean your anus with cotton balls that have been soaked in warm water. You may have better results if you add a little salt to the water.
  3. Talk to your healthcare provider. Your practitioner may recommend one or more of the following:
  • A suppository medication or a cream to reduce swelling and ease the pain
  • A botox injection
  • A minor surgical procedure is known as a lateral internal sphincterotomy

A Word From Verywell

You don't have to endure the pain of anal fissures without finding solutions to prevent them. While it may be embarrassing to discuss them with your healthcare provider, that is the best way to find solutions that will help end this problem.

IBS Doctor Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Man
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Choung RS, Rey E, Richard locke G, et al. Chronic constipation and co-morbidities: A prospective population-based nested case-control study. United European Gastroenterol J. 2016;4(1):142-51. doi:10.1177/2050640614558476

  2. Beaty JS, Shashidharan M. Anal Fissure. Clin Colon Rectal Surg. 2016;29(1):30-7. doi:10.1055/s-0035-1570390

  3. Schlichtemeier S, Engel A. Anal fissure. Aust Prescr. 2016;39(1):14-7. doi:10.18773/austprescr.2016.007

  4. Villalba H, Villalba S, Abbas MA. Anal fissure: a common cause of anal pain. Perm J. 2007;11(4):62-5. doi:10.7812/tpp/07-072

Additional Reading
  • Madalinski, M. "Identifying the best therapy for chronic anal fissure" World Journal of Gastrointestinal Pharmacology and Therapeutics 2011 2:9-16.
  • Minocha, A. & Adamec, C. (2011) The Encyclopedia of the Digestive System and Digestive Disorders (2nd Ed.) New York:Facts on File.

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.