Anal Fissure Treatment

An anal fissure is a common condition that can cause sharp pain and bleeding during bowel movements. Most fissures heal with simple measures at home, and treatment options are available if they do not. Our doctors will assess your symptoms, explain what is causing them and recommend an approach suited to you.

What is an Anal Fissure?

An anal fissure is a small cut or tear in the lining of the anus. It usually develops when straining to pass large or hard stools. The tear can cause pain, itching and a small amount of bright red blood during and after a bowel movement.

When should I see a doctor?

Consider seeing a doctor if you:

• Have pain during or after bowel movements that does not ease after about two weeks
• Notice blood on the toilet paper or in the toilet bowl
• Have symptoms that keep returning

Rectal bleeding can have causes other than a fissure, so it is important to have it checked by a doctor.

How are Anal Fissures Treated?

Most anal fissures do not need extensive treatment, and many heal on their own within a few weeks. Treatment usually begins with simple measures and moves on to other options only if needed.

Home care

• Stool softeners and fibre supplements to make stools easier to pass
• Drinking more fluids and eating more raw fruit and vegetables
• Topical creams that reduce pain and inflammation

Medicated ointments

If your symptoms are not relieved after about two weeks, your doctor may prescribe an ointment such as a calcium channel blocker. It relaxes the sphincter muscles around the anus, which allows the fissure to heal.

Botox Injections

Botulinum toxin (Botox) can be injected into the anal sphincter. Botox is used medically to stop muscles from contracting, which relaxes the sphincter and gives the fissure time to heal.

Anal sphincterotomy

Your doctor may recommend an anal sphincterotomy, a surgical procedure in which a small incision is made in the anal sphincter. This relaxes the muscle and allows the fissure to heal.

Your doctor will explain the options that suit your condition and answer any questions before you decide.

How can I Help Prevent Anal Fissures?

• Eat a diet rich in fibre, including fruit, vegetables and whole grains
• Drink enough fluids through the day
• Avoid straining or sitting for long periods on the toilet
• Do not delay going to the toilet when you feel the urge

Your doctor may also recommend an anal sphincterotomy, a surgical procedure where a small incision is made in the anal sphincter to relax the muscle, allowing the anal fissure to heal.