Anal fissure

Overview

The tear can cause a muscle spasm that keeps it from healing, so pain can last hours after a bowel movement.

A fissure that lasts more than 8 weeks is called chronic.

Symptoms

Common signs:

• Sharp pain with bowel movements
• Bright red blood on toilet paper
• Pain, itching, or swelling at the bottom
• Blood when wiping or on toilet paper

Less common

• Itching
• Muscle spasm

Look up a symptom: Blood when wiping or on toilet paper · Constipation · Pain, itching, or swelling at the bottom

When to get medical care

Causes

Hard stools, diarrhea, childbirth, and Crohn's disease.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• Constipation
• Infants
• After childbirth

Possible complications

• Hemorrhoids
• Constipation

Diagnosis

A clinician gently looks at the area.

Questions you may be asked

• Constipation, diarrhea
• Bleeding

The exam

A gentle outside exam.

Treatment

Soft stools let it heal.

Self-care

• Eat 25 to 35 grams of fiber a day
• Drink plenty of water
• Sit in a warm bath for 10 to 15 minutes after bowel movements
• Don't strain or sit on the toilet long

Medicines

Medicines that may help:

OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.

Botox shots or a small surgery help fissures that won't heal.

Prevention

To prevent it:

• High-fiber diet
• Don't strain

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a gastroenterologist or a colon and rectal surgeon.

Living with it

• Keep a simple diary of symptoms, triggers, and medicines to bring to visits.
• Bring a list of your medicines and questions to each visit.
• Note which foods make symptoms better or worse.
• Eat smaller meals and limit alcohol.
• Long-term illness can affect mood. Tell your doctor if you feel down or anxious.

Back to school, work, or sports

• Most people can keep working or going to school.
• Ask about changes that help, like extra breaks or a flexible schedule. Workers may be covered by the ADA. Students may get a 504 plan.

Children, pregnancy, and older adults

• Babies: Fissures are a common cause of blood in baby stool.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Most heal without surgery.

Getting ready for your visit

Bring a list of your symptoms and medicines.

Questions to ask

• Do I need a colonoscopy?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Anal fissure