Anal Fissure

What is it?

An anal fissure is a small tear in the lining of the anus. Sometimes they last for a short time and recovery is rapid. More commonly the condition recurs intermittently over months or years until the diagnosis is eventually made. They are the most common cause of anal pain.

 

What causes them?

Some fissures are caused when the patient strains to pass a large or hard piece of stool. More commonly it is due to the anal muscle failing to relax at the moment of defaecation.


Childbirth significantly increases the risk of developing an anal fissure.

 

What are the symptoms?

Pain, which is sharp and stinging when you have your bowels open and this may last for several hours afterwards.
There may be a discharge or some bright red blood on the toilet paper.

 

Treatment

In some cases the fissure will heal spontaneously. The aim is to relieve the pain and keep the stool soft. Hot baths taken after a bowel action will relieve the pain but it is only a temporary solution.


Creams which contain anaesthetic or a muscle relaxant are also very helpful. Eating plenty of fibre and taking a stool softening agent (eg psyllium husks) is also helpful.


If the pain persists then a chronic fissure has developed. This requires treatment with agents that relax the anal muscle such as Rectogesic or botox injections.

 

If the fissure fails to heal or if it recurs then an operation cures the problem.