Digestive Health Irritable Bowel Syndrome An Overview of Anal Fissures Treatment By Barbara Bolen, PhD twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Barbara Bolen, PhD Medically reviewed by Medically reviewed by Robert Burakoff, MD, MPH on October 19, 2020 linkedin Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Review Board Robert Burakoff, MD, MPH on October 19, 2020 Print An anal fissure is a tear in the tissue lining the anal canal. Such a break can cause severe pain and result in bleeding when you have a bowel movement. You may see bright red blood in your toilet or on your toilet paper. Anal fissures are not uncommon and can occur at any age. Hoxton / Sam Edwards / Getty Images Anal fissures are categorized as either acute or chronic. Acute anal fissures tend to be superficial and heal relatively quickly, without the need for medical intervention. Chronic fissures are those that have not healed within six weeks. Chronic anal fissures tend to be deeper than those that are acute. Symptoms Anal pain Anal itching Localized pain during bowel movements Bright red blood in stool Any sign of bleeding from the rectum or anus should be reported to your doctor for an accurate diagnosis. Causes Anal fissures are typically the result of some form of trauma to the anus. This trauma has been associated with a variety of causes, but most often is simply the result of a hard stool. Surprisingly, it is estimated that only a quarter of anal fissures are caused by constipation. (This is not a contradiction as it is possible to experience a hard stool without being constipated.) The associated trauma to the anus can also be the result of diarrhea episodes. Anal fissures are also thought to be more likely when there is excessive tension in the internal sphincter of the anus. There are some health conditions that are thought to increase the risk of experiencing an anal fissure: Chronic constipation Hypothyroidism Obesity Localized tumors Treatment If you are experiencing an anal fissure, you may find relief and encourage healing through the use of a sitz bath. Keeping your stool soft and being gentle when cleansing the area will also help. Don't try to avoid or postpone bowel movements; this will only serve to harden the stool and further exacerbate the problem. Should your symptoms persist, make an appointment with your doctor. There are several medical treatments that are available: Surgery - a procedure is known as lateral internal sphincterotomy (LIS) Medications - either topical or injected Botox injections Prevention The self-care tips for preventing anal fissures are similar to those for preventing hemorrhoids. Try to keep your stool soft by taking in plenty of dietary fiber and drinking lots of water. Be sure to cleanse the area gently. How to Prevent and Treat Painful Anal Fissures Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 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. Cleveland Clinic. Anal fissures. Updated February 22, 2019. 5-Minute Clinical Consult. Anal fissure. American Academy of Family Physicians. Anal fissure. Updated November 9, 2018. American Society of Colon and Rectal Surgeons. Anal fissure. Additional Reading Cheung, O. & Wald, A. "The management of pelvic floor disorders" Alimentary Pharmacology and Therapeutics 2004 19:481-495. Greenwald, D. "Common Disorders of the Anus and Rectum: Hemorrhoids and Fissures" The American College of Gastroenterology. Mapel, D., Schum, M. & Von Worley, A. "The epidemiology and treatment of anal fissures in a population-based cohort" BMC Gastroenterology 2014 14:129.