An anal fissure is a painful cut in the lining of the anus. The anus is the opening through which stool leaves the body. Tears generally occur just inside the opening.
A large, dry, or hard stool can tear the lining of the anus. Frequent diarrhea or irritation of the anus and rectum may also lead to a tear.
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for an anal fissure:
Symptoms of an anal fissure are similar to those of other more serious conditions. Therefore, you should see a doctor if you have these symptoms:
The doctor will ask about your symptoms and medical history. He or she will also do a physical exam. The anal area will be examined, which involves the following:
Fissures usually occur in predictable locations around the anus. If there are multiple cuts, or a cut in an unusual location, the doctor may order additional tests to look for other conditions.
Treatment aims to heal the cut and prevent future anal problems. About half of all fissures heal on their own or with self-care. Fissures that are fairly new are easier to heal than ones that have persisted for longer than three months.
To promote healing:
Some fissures may need surgery. Fissures may not heal by themselves, or you may have repeated ones. Scar tissue or spasms in the sphincter muscle, which closes and opens the anus, may also delay healing.
There are several surgical options. The most common surgery is called lateral internal sphincterotomy. During this procedure, the doctor will make a tiny incision and divide certain fibers of the sphincter muscle. This will prevent the muscle spasms that lead to straining with a bowel movement.
If you are diagnosed with an anal fissure, follow your doctor's instructions.
Most fissures are caused by hard, dry stool that is associated with constipation. To avoid becoming constipated:
American Academy of Family Physicians
The American Society of Colon and Rectal Surgeons
College of Family Physicians of Canada
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Last reviewed October 2012 by Daus Mahnke, MD