June 6, 2019

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:

Advertisement

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.

Related Articles

Closeup of people holding up shot glasses
February 15, 2024
What Does Alcohol Do to Your Body? 9 Ways Alcohol Affects Your Health

Alcohol affects your whole body, from your liver and immune system to your brain and mental health

Two bariatric surgery options: grastric bypass and gastric sleeve
February 14, 2024
How To Know Which Type of Bariatric Surgery Is Right for You

Gastric bypass and sleeve gastrectomy are different procedures that offer similar benefits, including significant weight loss

person practicing mindfulness at night time on a yoga mat
February 5, 2024
Living Well With Crohn’s Disease: 8 Self-Care Tips

Studies show a strong self-care regimen can improve symptoms and overall health

Person clutching stomach, with over-sized digestive track in background
January 30, 2024
A Nutritional Plan for Anyone Living With Crohn’s Disease or Ulcerative Colitis

If you have IBD, there are roughly nine food types that might contribute to inflammation flare-ups

group of people doing an aerobics class
January 26, 2024
How Exercise Can Lead to a Healthy Gut

You don’t need a strenuous or expensive fitness routine to keep your digestive tract in shape

person walking away from toilet holding upset stomach
January 24, 2024
Fried Rice Syndrome: Why It Happens and How To Avoid It

Keep cooked rice and pasta in your fridge — not on your counter — to help prevent this sneaky food poisoning

Person lifting up their sweater, showing ostomy bag in mirror's reflection
December 5, 2023
Adjusting to Life With an Ostomy Bag: What To Expect

It can be hard to get used to the bags, but the freedom they provide is worth the challenge

illustration of a hernia
October 19, 2023
Can Heavy Lifting and Exercise Cause a Hernia?

We can’t predict who’ll develop a hernia, but the benefits of being active far outweigh the risk

Trending Topics

close up of keto gummies
Do Keto Gummies Work for Weight Loss? Are They Safe?

Research is inconclusive whether or not these supplements are helpful

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

Older person postioned sideways showing dowager hump.
Dowager’s Hump: What It Is and How To Get Rid of It

The hump at the base of your neck may be caused by osteoporosis or poor posture

Ad