Anal Fissure, Adult

An anal fissure is a small tear or crack in the skin around the anus. Bleeding from a fissure usually stops on its own within a few minutes. However, bleeding will often reoccur with each bowel movement until the crack heals.

CAUSES

  • Passing large, hard stools.

  • Frequent diarrheal stools.

  • Constipation.

  • Inflammatory bowel disease (Crohn's disease or ulcerative colitis).

  • Infections.

  • Anal sex.

SYMPTOMS

  • Small amounts of blood seen on your stools, on toilet paper, or in the toilet after a bowel movement.

  • Rectal bleeding.

  • Painful bowel movements.

  • Itching or irritation around the anus.

DIAGNOSIS 

Your caregiver will examine the anal area. An anal fissure can usually be seen with careful inspection. A rectal exam may be performed and a short tube (anoscope) may be used to examine the anal canal.

TREATMENT

  • You may be instructed to take fiber supplements. These supplements can soften your stool to help make bowel movements easier.

  • Sitz baths may be recommended to help heal the tear. Do not use soap in the sitz baths.

  • A medicated cream or ointment may be prescribed to lessen discomfort.

HOME CARE INSTRUCTIONS

  • Maintain a diet high in fruits, whole grains, and vegetables. Avoid constipating foods like bananas and dairy products.

  • Take sitz baths as directed by your caregiver.

  • Drink enough fluids to keep your urine clear or pale yellow.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Do not take aspirin as this may increase bleeding.

  • Do not use ointments containing numbing medications (anesthetics) or hydrocortisone. They could slow healing.

SEEK MEDICAL CARE IF:

  • Your fissure is not completely healed within 3 days.

  • You have further bleeding.

  • You have a fever.

  • You have diarrhea mixed with blood.

  • You have pain.

  • Your problem is getting worse rather than better.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.