Anal Fissures

Anal Fissures

An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements and are commonly thought of as hemorrhoids. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter).

Anal fissures are very common in young infants but can affect people of any age. An anal fissure usually heals on its own within four to six weeks. If it doesn’t, medical treatment or surgery usually can relieve discomfort.

Symptoms of Anal Fissures

People with anal fissures almost always experience pain that worsens with bowel movements. However, the pain usually subsides between bowel movements. This is one major difference between hemorrhoids, as hemorrhoid pain tends to be longer lasting. The pain can be so severe that patients are unwilling to have a bowel movement, resulting in constipation and even fecal impaction. Moreover, constipation can result in the passage of a larger, harder stool that causes further trauma and makes the fissure worse. The pain also can affect urination by causing discomfort when urinating (dysuria), frequent urination, or the inability to urinate. Bleeding in small amounts, itching (pruritus ani), and a malodorous discharge may occur due to the discharge of pus from the fissure.

Causes of Anal Fissures

Anal fissures are caused by trauma to the anus and anal canal. The cause of the trauma usually is a bowel movement, and many people can remember the exact bowel movement during which their pain began. The fissure may be caused by a hard stool or repeated episodes of diarrhea. Occasionally, the insertion of a rectal thermometer, enema tip, endoscope, or ultrasound probe (for examining the prostate gland) can result in sufficient trauma to produce a fissure. During childbirth, trauma to the perineum (the skin between the posterior vagina and the anus) may cause a tear that extends into the anoderm.

Common causes of anal fissure include:

  • Passing large or hard stools
  • Constipation and straining during bowel movements
  • Chronic diarrhea
  • Inflammation of the anorectal area, caused by Crohn’s disease or another inflammatory bowel disease
  • Childbirth

Less common causes of anal fissures include:

  • Anal cancer
  • HIV
  • Tuberculosis
  • Syphilis
  • Herpes

Treatments for Anal Fissures

Anal fissures typically heal on their own within four to six weeks, but it’s important to seek medical attention right away. Anal fissures could become more serious and possibly be an entirely different disorder such as hemorrhoids. Seek the help of Dr. Akopian, Colorectal Specialist today for anorectal pain and anal fissure symptoms.


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Pasadena, CA 91105

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