What is an anal fissure?

The anal canal is a short tube surrounded by muscle at the end of your rectum. The rectum is the bottom section of your colon (large intestine). An anal fissure (also called fissure-in-ano) is a small rip or tear in the lining of the anal canal. Fissures are common, but are often confused with other anal conditions, such as hemorrhoids.

What causes anal fissures?

Fissures are usually caused by trauma to the inner lining of the anus from a bowel movement or other stretching of the anal canal. This can be due to a hard, dry bowel movement or loose, frequent bowel movements. Patients with a tight anal sphincter muscle are more likely to develop anal fissures. Less common causes of fissures include inflammatory bowel disease, anal infections, or tumors.

What are the symptoms of anal fissures?

Anal fissures typically cause a sharp pain that starts with the passage of stool. This pain may last several minutes to a few hours. As a result, many patients may try not to have bowel movements to prevent pain. Other symptoms include: bright red blood on the stool or toilet paper after a bowel movement, or a small lump or skin tag on the skin near the anal fissure (more common when chronic).

What treatments are available?

There are non-surgical and surgical options for treatment. Although most anal fissures do not require surgery, chronic fissures are harder to treat and surgery may be the best option.

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