An anal fissure is a small tear in the lining of the anus, and despite its size it can cause sharp, surprising pain, especially during and after a bowel movement. The good news is that most fissures heal with simple care at home. Here is how to speed that along, what to avoid, and when it is time to see a colorectal surgeon.
What is an anal fissure?
An anal fissure is a small split or tear in the thin, sensitive lining of the anal canal. The classic signs are a sharp, tearing pain during bowel movements and a small amount of bright red blood on the toilet paper or stool. Many people describe it as “passing shards of glass.” It is common, and it is usually benign.
Why fissures hurt so much
The anal canal is full of nerve endings, so even a small tear is painful. Worse, the pain can trigger a spasm in the muscle around the anus, which reduces blood flow to the area and keeps the fissure from healing. That cycle of spasm, pain, and poor healing is why some fissures linger.
What causes anal fissures
- Passing hard or large stools
- Constipation and straining
- Bouts of diarrhea
- Childbirth
- Less commonly, underlying conditions such as inflammatory bowel disease
How to heal an anal fissure fast
Most fissures respond to a few simple steps, and they all share one goal: soften the stool, calm the spasm, and let the tear heal.
- Add fiber and fluids. Soft, easy-to-pass stool is the single most important factor. Get more fiber from food or a supplement, and drink plenty of water.
- Take warm sitz baths. Sitting in a few inches of warm water for 10 to 15 minutes, several times a day and after bowel movements, relaxes the muscle and eases pain.
- Use a stool softener if you need one to avoid straining.
- Keep the area clean and dry, patting rather than rubbing.
- Ask about topical treatments. Over-the-counter creams can soothe, and your physician may prescribe an ointment that relaxes the muscle and improves blood flow to help the fissure heal.
Most acute fissures improve within a couple of weeks with this approach.
What not to do
- Do not ignore constipation. Hard stools reopen the tear.
- Do not ignore diarrhea. Liquid stools can also aggravate the tear.
- Do not strain or sit on the toilet for long stretches.
- Do not rely on numbing creams alone while the stool stays hard. They mask the pain without fixing the cause.
When home care is not enough
A fissure that lasts more than six to eight weeks is considered chronic and often needs more than home care. A colorectal surgeon has effective options, including:
- Prescription ointments that relax the anal muscle, which allows healing to take place.
- A minor surgical procedure that relaxes the muscle either temporarily by relaxing the muscle with an injection, or permanently by dividing a small portion of the muscle.
When to see a colorectal surgeon
See a specialist if:
- The pain or bleeding lasts more than a few weeks despite home care
- Fissures keep coming back
- You notice a lump, or the bleeding is heavy or persistent
Persistent or recurring fissures rarely heal on their own once the spasm cycle sets in. A specialist can break that cycle and keep the fissure from returning.
Importantly, rectal bleeding should be adequately evaluated to rule out more serious causes such as colon cancer.
🩺 [An anal fissure is one of the most common causes of rectal pain. It often resolves without surgery, and we offer effective surgical treatment when necessary.] Dr. Lee.
Frequently asked questions
How long does an anal fissure take to heal?
Most acute fissures heal within two to six weeks with stool softening and sitz baths. A fissure lasting beyond six to eight weeks is chronic and may need a specialist.
What is the fastest way to heal an anal fissure?
Keep stool soft with fiber and fluids, take warm sitz baths to relax the muscle, and avoid straining. That combination addresses the cause and the spasm at the same time.
Will an anal fissure heal on its own?
Many acute fissures do, with good home care. Chronic or recurring fissures usually need treatment to break the muscle-spasm cycle.
When should I see a doctor for an anal fissure?
If pain or bleeding lasts more than a few weeks, keeps coming back, or the bleeding is heavy, see a colorectal surgeon. Always get rectal bleeding checked.
Get relief from the pain
If a fissure is not healing, or it keeps coming back, you do not have to live with the pain. Request a fissure evaluation with Colon Rectal Specialists or call (248) 852-8020
