Anal Fissures

Anal Fissures: Causes, Symptoms & Treatment

Anal fissures are a common condition that occur when the skin lining the anus becomes torn or cracked. This can cause pain and small amounts of bleeding, usually during and after a bowel movement. Anal fissures are often confused with hemorrhoids, however, while they can both cause similar symptoms such as anal pain and itchiness, they’re not the same condition.

The exact cause of an anal fissure is not known, but it is usually caused by a trauma to the anal area such as constipation, chronic diarrhea, childbirth, surgery, or even an accident.

Symptoms of Anal Fissures

  • Pain during and after bowel movements
  • Itching in the anal area
  • Bleeding
  • Swelling and irritation around the anal area
  • A crack or tear in the skin of the anus

Diagnosis and Treatment

Anal fissures are usually diagnosed based on a physical exam and patient history. Your doctor may also recommend various tests, such as a colonoscopy, to rule out other conditions that may cause similar symptoms. Treatment of anal fissures typically involve medication and lifestyle changes.


Medication can help reduce pain, inflammation, and spasms in the muscles surrounding the anal opening. Medication may include topical numbing creams or ointments, muscle relaxants, topical anesthetics, or anti-inflammatory medications.

Lifestyle Changes

In addition to medication, lifestyle changes may be necessary to help reduce the pain associated with anal fissures and to help prevent them from recurring. These changes may include increased fiber and water intake to help soften stool, and regular exercise to help reduce stress.


In some cases, surgery to repair the tear may be necessary. Surgery is typically recommended for anal fissures that do not respond to other treatments, or if the tear is larger or deeper. Common surgical procedures used to treat anal fissures include incision and advancement flap, and internal sphincterotomy.