About this condition
An anal fissure is a small tear in the lining of the anal canal. It can cause sharp pain during bowel movements and spots of bright-red blood on paper. Other causes of pain and bleeding still need to be considered.
What you should know
A fissure can follow hard stool or repeated diarrhoea. Spasm of the internal anal sphincter may prolong pain and slow healing. Recent and persistent fissures require assessment of their course, not only a count of days.
Symptoms and reasons for assessment
Typical features are cutting pain when passing stool, burning for minutes or hours afterwards and a small amount of fresh blood. People may delay bowel movements because they fear pain, which can worsen constipation. Pain severity does not necessarily reflect tear size.
Other possible explanations
Haemorrhoids, inflammation, abscesses and other conditions can produce similar complaints. Unusual locations or multiple fissures may call for investigation of an underlying problem, including inflammatory bowel disease.
How the condition is assessed
The clinician asks about pain, constipation, duration and medical history. Gentle external inspection is often sufficient initially; painful instrumental examinations may be postponed. Further tests are guided by warning signs.
Treatment and follow-up options
Initial treatment commonly focuses on achieving soft regular stool, reducing local trauma and managing pain. A clinician may prescribe topical medication to relax the sphincter. Persistent cases may require procedures or surgery after discussing possible risks to bowel control.
When urgent care is needed
Severe pain with fever, swelling or pus requires urgent assessment to exclude an abscess. Significant uncontrolled bleeding or collapse is an emergency: call 103.
Related health information
Pain around the anus; Bleeding during bowel movements; Haemorrhoids.
Signs and symptoms
Diagnosis and tests
Care and treatment approaches
When to seek urgent care
Frequently asked questions
Can an anal fissure heal without an operation?
Yes. Many recent fissures improve with stool regulation and appropriate conservative treatment.
Why can pain continue after a bowel movement?
Spasm of the anal sphincter can maintain pain after stool has passed.
When might an operation be considered?
Persistent symptoms despite appropriate care may lead to discussion of procedural or surgical options and their risks.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
