Anal Fissure: Stages, Symptoms & Treatment
A simple guide for patients to understand what an anal fissure is, how to detect it, and the treatment options available.
What is an anal fissure?
An anal fissure is a small tear in the lining of the anus. It often causes severe pain during bowel movements and bright red bleeding. Fissures are commonly due to constipation, passing hard stools, or prolonged diarrhea. Most heal with simple care, but some can become chronic and need medical treatment.
General symptoms patients notice
- Sharp, cutting pain during and after passing stool
- Bright red blood on toilet paper or in stool
- Burning or stinging sensation around the anus
- Spasm of anal muscles making stool passage difficult
- Itching or irritation in the anal area
- Visible small crack or tear near the anus (sometimes)
How severity progresses
Stages of fissure & what to do
Stage 1: Acute fissure
Symptoms: Sharp pain during bowel movement, mild bleeding, discomfort afterward.
What to do: Eat fiber-rich food, drink water, avoid straining, take sitz baths, use stool softeners, and apply prescribed ointments for relief.
Stage 2: Chronic fissure
Symptoms: Pain lasting more than 6–8 weeks, recurrent bleeding, muscle spasms, sentinel skin tag near the tear.
What to do: Medical treatment is necessary. Doctors may prescribe ointments that relax anal muscles or suggest Botox injections. Surgery may be considered if conservative methods fail.
Stage 3: Complicated fissure
Symptoms: Severe pain, persistent bleeding, non-healing tear, associated with other diseases (e.g., Crohn’s).
What to do: Requires specialist consultation. Advanced treatment may include lateral internal sphincterotomy (a minor surgery) or other surgical options for lasting relief.
Prevention & self-care tips
- Eat a diet high in fiber to avoid constipation
- Drink at least 8 glasses of water daily
- Avoid prolonged straining while passing stool
- Take sitz baths regularly if you have anal discomfort
- Maintain good anal hygiene
- Exercise regularly to improve bowel function
When should you see a doctor?
- Pain and bleeding persisting beyond 1–2 weeks
- Fissures that keep coming back
- Severe pain interfering with daily life
- Bleeding that seems heavy or recurrent
FAQs
Can fissures heal on their own?
Yes, most acute fissures heal within a few weeks with simple measures like fiber intake, sitz baths, and ointments. Chronic fissures usually need medical help.
Which doctor should I consult?
A general surgeon or a colorectal surgeon is the right specialist for fissure treatment.
Is fissure surgery safe?
Yes. Procedures like lateral internal sphincterotomy are minor, safe, and provide lasting relief in chronic cases.