ANAL FISSURES What is a fissure?

31 Mar


What is a fissure?An anal fissure is a small tear in the skin that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. An anal fissure typically causes pain and bleeding with bowel movements.

Anal fissures most often affect people in middle age, but fissures also are the most common cause of rectal bleeding in infants. Most anal fissures heal within a few weeks with treatment for constipation, but some fissures may become chronic


Anal fissures can be caused by trauma to the anus and anal canal. The cause of the trauma can be one or more of the following:

Chronic constipation

Straining to have a bowel movement, especially if the stool is large, hard, and/or dry

Prolonged diarrhea

Anal stretching

Insertion of foreign objects into the anus

Other causes of anal fissures (other than trauma) include:

Longstanding poor bowel habits

Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus)

Scarring in the anorectal area

Presence of an underlying medical problem: such as Crohn’s disease and ulcerative colitis; anal cancer; leukemia; infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia, chancroid, HIV)

Decreased blood flow to the anorectal area


Signs and symptoms include:

Pain during, and even hours after, a bowel movement


Blood on the outside surface of the stool

Blood on toilet

A visible crack or tear in the anus or anal canal

Burning and itch that may be painful

Discomfort when urinating, frequent urination, or inability to urinate

Foul-smelling discharge


Factors that may increase your risk of developing an anal fissure include:

Infancy. Many infants experience an anal fissure during their first year of life, although experts aren’t sure of the reason.

Aging. Older adults may develop an anal fissure partly because of slowed circulation, resulting in decreased blood flow to the rectal area.

Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.

Childbirth. Anal fissures are more common in women after they give birth.

Crohn’s disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing


For fissures in adults:

Keep the anorectal area dry

Wipe the area with soft materials, a moistened cloth, or cotton pad; avoid rough and scented toilet paper

Promptly treat all occurrences of constipation and diarrhea

Avoid irritating the rectum


Ayurveda advises internal medication as well as topical ointment application in the treatment of anal fissures. To avoid further irritation to the damaged tissue, medicines which soften the stools and promote healing of the tissues are utilized. Ointments which are natural anti-bacterial and anti-septic are used for topical application.


Complications of anal fissure can include:

Anal fissure that fails to heal. An anal fissure that doesn’t heal can become chronic, meaning it lasts for more than six weeks.

Anal fissure that recurs. If you’ve experienced anal fissure once, you have an increased risk of another anal fissure.

A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter). This makes it more difficult for your anal fissure to heal. An unhealed fissure may trigger a cycle of discomfort that may require medications or surgery to reduce the pain and repair or remove the fissure.

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