Home Remedies for Anal Fissures

There are several comfort measures that can ease the pain and promote healing

Adding fiber to your diet

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A fissure is a tear or a break in the lining of the anal canal (the last part of the large intestine, where stool passes out of the body) is called an anal fissure. Some of the symptoms of an anal fissure include pain, bleeding, itching, and pain during bowel movements.

In cases of superficial fissures, although they are painful and may cause bleeding, they may heal on their own. Deeper fissures that become chronic may require treatment from a physician (such as a gastroenterologist).

Treatment at home for uncomplicated anal fissures can include eating more fiber, using stool softeners, drinking more water, using sitz baths, and using a local anesthetic to decrease pain. Fissures can cause a decrease in quality of life because of the discomfort but treatment at home is usually successful to heal them.

Any blood in or on the stool should always prompt a trip to the physician. Even if there has been a diagnosis of fissures in the past and the pain or other symptoms are recognizable, a new instance of blood in the toilet should be diagnosed to make sure it’s not another condition that may be more serious.

Causes of Anal Fissures

An anal fissure is caused by some type of trauma occurring in the anal canal. These tears in the anal canal can happen to anyone, but are more common in those who are younger and considered otherwise healthy. Uncomplicated fissures are called primary fissures.

A fissure could be caused by diarrhea, constipation, or from unusually high tension in the muscles of the anal sphincter. These fissures may also occur during childbirth, especially after a difficult delivery or one that was instrument-assisted.

In the past, it was thought that most fissures were caused by straining to pass stool. However, it’s now known that the tone of the sphincter muscles may be the cause of chronic fissures. Excessive tension may lead to the fissure, which in turn leads to pain, spasms, and more tension, potentially causing a fissure to become chronic.

Some of the conditions that are associated with primary anal fissures include:

  • Chronic constipation
  • Hypothyroidism 
  • Obesity
  • Tumors (which is uncommon)

Secondary fissures are those that can occur along with other conditions such as inflammatory bowel disease (Crohn’s disease and ulcerative colitis), tuberculosis, sarcoidosis, HIV/AIDS, or syphilis. Fissures associated with these diseases, infections, or conditions may become chronic and take longer to heal or require intervention such as surgery.

Anal fissures are painful, in part, because there is still a need to have bowel movements while they are healing. It will be important to keep stools soft and easily passed in order to avoid causing more discomfort.

In addition, there are some self-care measures that may aid in not only reducing the associated pain but also in helping the fissure to heal more quickly.

Sitz Baths

Taking a sitz bath means to sit in a few inches of warm water to ease conditions in anal area like a fissure. A sitz bath may relieve pain, but it may not speed healing of the anal fissure.

Sitz baths look like plastic tubs and can be purchased at most drugstores. They are used by putting them on top of a toilet and then filling with warm water. The water slowly leaves the tub through a tube or a small hole. It’s usually recommended that a sitz bath is used for about 10 or 15 minutes at a time.

In some cases, Epsom salts or other additives may be put in the sitz bath but these should only be used on the recommendation of a physician. Some people use their bathtub if they don’t have access to a plastic sitz bath, but it is important to clean the tub well beforehand and not to sit in it for too long.

Eating More Fiber

The American Heart Association recommends that most adults eat between 25 and 30 grams of fiber each day. However, many adults in the United States do not achieve this goal on a daily basis.

The reason for eating the appropriate amount of fiber is that it helps prevent stools from being too hard (constipation) or too liquid (diarrhea). A soft, easily passed stool will be less traumatic on the fissure area and prevent it from becoming further irritated.

Some examples of high fiber foods include:

  • High fiber bran cereal
  • Beans (navy, white, yellow, pinto, black turtle, mung, black, lima, great northern, kidney, cranberry, baked)
  • Shredded wheat cereal 
  • Split peas
  • Chickpeas
  • Lentils
  • Artichoke (globe or French)
  • Pigeon peas
  • Cowpeas
  • Wheat bran flakes
  • Pumpkin seeds
  • Soybeans
  • Plain rye wafer crackers
  • Avocado

Fiber Supplements

If enough fiber can’t be gotten throughout the day in food, a fiber supplement may help. Fiber supplements come in various forms, with some of the common main ingredients being psyllium, methylcellulose, and polycarbophil.

It is important to start slowly with fiber supplements and increase the amount used over time to avoid side effects such as abdominal bloating and gas. It may take some trial and error to understand which fiber supplement at what dosage is the “right” one.

Fiber supplements can be taken long-term and they are helpful in treating both constipation and diarrhea.

Stool Softeners

A stool softener may help in preventing constipation. Stool softeners are not laxatives and are usually considered safe and associated with few side effects. The way these agents work is that they help pull more water into the digestive tract, which softens stool.

There are several formulations including liquid, capsule, and tablet. Stool softeners are usually used for about a week.

Other lifestyle changes should be put into place to help with constipation in order to discontinue the stool softeners. Check with a physician about which over-the-counter stool softener may be most helpful.

Drinking More Water

Being dehydrated can contribute to the development of constipation. Drinking water can help keep stools soft and easier to pass. Foods with higher water content can also contribute to an overall water intake goal.

How much water to drink every day is individualized, but it’s recommended in general that men drink about 13 cups and women about 9 cups. More is needed after exercise or while pregnant or breastfeeding.

It may be that one’s own body is the best gauge for how much is needed. When stools are soft and easily passed, it may mean that enough water is being taken in during the day.

Some foods with high water content include:

  • Broccoli
  • Cabbage
  • Cantaloupe
  • Celery
  • Cucumber
  • Lettuce
  • Spinach
  • Strawberries
  • Sweet peppers
  • Tomato
  • Watermelon
  • Zucchini

Caring for Perianal Skin

Keeping clean after bowel movements can be a challenge with a fissure. If wiping is causing pain, using a bidet or a hand shower to clean up may be gentler.

Instead of toilet paper, gentle, fragrance-free wet wipes may also work (but don’t flush them as they may clog up the plumbing). Flannel washcloths may also help, for those that don’t mind doing a bit of laundry.

Preventing Anal Fissures

For those who are prone to developing anal fissures, prevention is key to avoiding the trauma and the subsequent pain and discomfort. It is important to keep stools soft and easily passed and prevent both constipation and diarrhea. That, in turn, can prevent the straining and the increase in sphincter tone that may contribute to the development of anal fissures.

The measures used to treat an anal fissure may help in preventing one as well:

  • Avoid straining during bowel movements. Trying to consciously relax the muscles in the anal canal during a bowel movement can help avoid that increase in sphincter tone that may lead to fissures.
  • Go to the bathroom when you feel the urge. Holding on to a bowel movement for a long period of time can mean that it becomes harder to pass, which is something to be avoided.
  • Ask your doctor about bowel retraining. For those who live with bowel conditions such as chronic constipation or constipation-predominant irritable bowel syndrome (IBS), strategies that can help make bowel movements more comfortable may help.

A Word From Verywell

Anal fissures are embarrassing, painful, and can have a detrimental effect on quality of life. Fortunately, most anal fissures are considered “acute” and will heal on their own at home. The key is to reduce the discomfort while promoting healing in the area.

Treating fissures should always be done with the help of a physician, even if they’ve been a problem in the past and it seems like the same treatment might be prescribed again.

Engaging a healthcare provider will give the best chance of healing up the area without any long-term problems, or having the fissure become chronic (which are more difficult to heal). 

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Article 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.
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