Locations:
Search IconSearch

How You Can Deal With Anal Fissures

Advice for prevention and treatment

feet in a bath

Anytime you have pain, bleeding and itching in your anal area, you’re going to worry.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

First, these are all uncomfortable sensations — there’s no getting around that. And second, they can be scary and make you wonder, “What’s going on?”

Many patients will assume hemorrhoids are to blame, but colorectal surgeon Massarat Zutshi, MD, says there’s another common culprit behind symptoms such as these: anal fissures.

Anal fissures are small tears in the skin around your anus. They commonly cause itching and bleeding, and they tend to cause more pain than most types of hemorrhoids. When you have these symptoms, a doctor can help you get an accurate diagnosis — and the right kind of relief.

Risk factors — and how to lower them

Anal fissures can happen to just about anyone, but there are definitely factors that raise your risk. Constipation is a major one, Dr. Zutshi says. Hard stool and straining on the toilet can put stress on your body and lead to these tears.

The same is true of diarrhea, even though it’s quite different from constipation. “Anytime you have a change in your bowel habits that puts stress on your system, your risk goes up,” she explains. “That’s why we often see people come in with anal fissures after traveling, when changing diets put the digestive system to the test.” Likewise, childbirth and the resulting stress on the body’s muscles and tissues can lead to fissures.

Fortunately, you can take preventive steps to lower your risk. They’re fairly simple:

Drink plenty of water. Hydration helps you avoid constipation.

Take an over-the-counter stool softener to avoid hard, dry bowel movements. Keeping things flowing through your body can help you avoid fissures. This is often good advice after childbirth in particular.

Watch your diet, and make sure you’re getting plenty of fiber and leafy greens. For protein, choose lean meats and fish over red meat. And don’t eliminate all fat from your diet, because fat and oil are good lubricants that keep your digestive tract functioning properly.

What to do if you have a fissure

First, a doctor will want to rule out other conditions with similar symptoms, as well as abscesses, infections, inflamed skin tags or hemorrhoids — or other more serious concerns, Dr. Zutshi says.

Next, in conjunction with the lifestyle changes outlined above, treatment for a fissure usually starts conservatively with simple at-home fixes and conservative medical therapy.

At home: A “sitz bath” — soaking in warm, but not hot, water several times a day — works wonders for many patients. The pain many people feel before or right after a bowel movement comes from muscle spasms brought on by the anal fissure. Warm baths help those muscles relax, which in turn helps the fissure heal over time.

Advertisement

Medical management: Medical therapy targets the muscles, too. A doctor may offer a specific ointment that relaxes the anal muscles so the fissure can heal, minus the spasms. A numbing agent such as lidocaine is an option, too. However, it may add to the burning and irritation.

Surgical options: When conservative treatments don’t work, there are two simple outpatient surgical options. One is a Botox injection into the anal muscles. This basically paralyzes the muscle to prevent spasms and allow the fissure to heal. The other option is sphincterotomy, a strategic cut to the muscle that also relieves spasms. Both come with a healing time of around two weeks.

The best option comes down to your individual needs, Dr. Zutshi says. For example, a sphincterotomy has a slight risk of causing long-term bowel control issues, so it may not be recommended for people who already have those issues, especially women. The same is true of people with Crohn’s disease or HIV, two groups with an increased risk of anal fissures. For these populations, Botox may be a better option if surgery is required.

The bottom line — no pun intended — is that you have plenty of options to treat this irritating condition. When you suspect an anal fissure, see a doctor to confirm those suspicions and find out which options are best for you.

Advertisement

Learn more about our editorial process.

Related Articles

Person in bathroom holding stomach and hand over mouth
June 10, 2024/Digestive
Why Am I Throwing Up? And When To See a Doctor

The stomach flu, food poisoning and motion sickness can make you vomit and may result in dehydration

Assorted healthy foods spread out over a table and cutting boards
May 20, 2024/Digestive
What To Eat When You Have Diverticular Disease

Reducing inflammation is key when you’re in a flare-up, but so is having a preventive nutritional plan in place when you’re not

Colonscopy exam showing light inside colon
March 15, 2024/Digestive
How Safe Are Colonoscopies?

They might not be fun, but colonoscopies are low-risk, high-reward procedures

Female and male waking up with hangovers in aftermath of a party
March 13, 2024/Digestive
Hangover Pills Aren’t Worth the Hype

Misleading claims, lack of scientific evidence and the risk of over-doing it are all concerns

Counter top with healthy foods and meal prepping
March 11, 2024/Digestive
Living With Celiac Disease? Make Time for Self-Care

It’s more than just avoiding gluten — it’s also important to focus on your mental and emotional health

person eating a small lunch alone at desk at the office
March 8, 2024/Digestive
How To Cope With Ulcerative Colitis at Work

Talk to your employer, ask for accommodations and manage your stress

person speaking with healthcare provider in office
March 4, 2024/Digestive
Ulcerative Colitis and Your Mental Health

Seeking help through therapy can be an important step in improving your quality of life when you have UC

Physician examines oversized colon with giant magnifying glass, with report in foreground
March 1, 2024/Digestive
Colon Cancer Screenings: When To Start

If you’re at average risk, it’s recommended that you get your first colonoscopy at age 45

Trending Topics

Female and friend jogging outside
How To Increase Your Metabolism for Weight Loss

Focus on your body’s metabolic set point by eating healthy foods, making exercise a part of your routine and reducing stress

stovetop with stainless steel cookware and glassware
5 Ways Forever Chemicals (PFAS) May Affect Your Health

PFAS chemicals may make life easier — but they aren’t always so easy on the human body

jar of rice water and brush, with rice scattered around table
Could Rice Water Be the Secret To Healthier Hair?

While there’s little risk in trying this hair care treatment, there isn’t much science to back up the claims

Ad