Anal fissure

fissures, torn rectum

Basic Information

What is Anal fissures?

A laceration, tear, or crack in the lining of the anus. It affects all age groups, including infants.

Frequent signs and symptoms

  • Sharp pain with passage of a hard or bulky stool. The pain may last up to an hour and returns with the next bowel movement.
  • Pain when sitting on a hard surface.
  • Streaks of blood on the toilet paper, underwear or diaper.
  • Itching around the rectum.
  • Children may refuse to have a bowel movement.


The exact cause is unknown, but the symptoms usually occur after the stretching of the anus from a large, hard stool.

Risk increases with

Preventive measures

  • Avoid constipation by:
    Drinking at least 8 glasses of water daily. Eating a diet high in fiber. Using stool softeners or other laxatives, if needed.
  • Don't strain at stool.
  • Avoid anal intercourse.

Expected outcomes

Most adults recover in 4 to 6 weeks with treatment, making surgery unnecessary. Most infants and young children recover after the stool is softened.

Possible complications

Permanent scarring that prevents normal bowel movements.

Anal Fissures Treatment

General measures

  • Examination of the anus and rectum with an anoscope or sigmoidoscope to rule out other causes of anal or rectal bleeding.
  • Gently clean the anus with soap and water after each bowel movement.
  • To relieve muscle spasms and pain around the anus, apply a warm towel to the area.
  • Sitz baths also relieve pain. Use 8 inches of warm water in the bathtub, 2 or 3 times a day for 10 to 20 minutes.
  • Surgery may be necessary, if conservative treatment is not successful, to remove the fissure or to alter the muscle that contracts and prevents normal healing.


  • For minor pain, use non-prescription drugs, such as acetaminophen or topical anesthetics.
  • Zinc oxide ointment or petroleum jelly applied to the anal opening may help prevent the burning sensation.
  • Bulk stool softeners will help to avoid the pain occurring with bowel movements.
  • Lidocaine ointment may be recommended.
Information Brand Generic Label Rating
Viagra Viagra Sildenafil Off-Label
Adalat Nifedipine


No restrictions. Physical activity reduces the likelihood of constipation.


Encourage a high-fiber diet and extra fluids to prevent constipation.

Notify your physician if

You or your child has symptoms of an anal fissure, especially pain that persists despite treatment.

Last updated 23 December 2015


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