Anal fissures
from symptoms to treatment
What should I know about the anal canal?
The anal canal is the final segment of the rectum. It connects to the skin in the anal margin and is surrounded by the anal sphincter – the muscles that form the internal and external sphincter, the latter of which is under voluntary control.
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What are the symptoms of an anal fissure?
- Pain is typically felt as a burning sensation, especially during bowel movements. Once the stool has passed, the pain diminishes but tends to return in the hours that follow
- Blood on the stool or toilet paper
- Anal itching
- Anal contraction due to a muscle spasm in the anal sphincter
- Functional constipation (voluntary withholding of stool) due to fear of painful bowel movement
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What are the risk factors of anal fissure?
- Generally bouts of constipation; but sometimes frequent, liquid stools
- Childbirth (anterior anal fissure)
- Chronic inflammatory bowel disease
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How is an anal fissure diagnosed?
The diagnosis is based on a clinical exam performed to locate the fissure, which is generally an ulcer located toward the back of the anus. However, the exam is often difficult to perform because of the pain it triggers. Chronic fissures are generally accompanied by a small lump of skin on the outside and/or a hypertrophied papilla in the anal canal.
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What are the treatment options for anal fissures?
The aim of treatment is to eliminate pain, promote healing and prevent recurrence. The first phase of treatment is medical, and includes pain killers, laxatives and topical remedies to promote healing.
Surgery may be an option if the medical treatment fails or if the fissure becomes infected.
Key figures
- Fissures are the leading cause of anal pain
- Anal fissures are the second most common condition affecting the anus after hemorrhoids.
- Close to 50 percent of anal fissures heal with medical treatment.
Consult our gastroenterologists
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