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ANAL FISSURE

BASIC INFORMATION

DESCRIPTION

Anal fissure is a laceration, tear, or crack in the anal

canal. It can affect all age groups, including infants.
FREQUENT SIGNS & SYMPTOMS

• Sharp pain with passage of a hard or bulky stool. The

pain may last up to an hour, and returns with the next

bowel movement.

• Pain when sitting on a hard surface.

• Streaks of blood on the toilet paper, underwear, or

diaper.

• Itching around the rectum.

• Refusal to have a bowel movement (in children).
CAUSES

The exact cause is unknown. Symptoms usually occur

after the stretching of the anus from a large, hard stool.
RISK INCREASES WITH

• Constipation or prolonged diarrhea.

• Childbirth.

• Inflammatory bowel disease (e.g., Crohn’s disease).

• Certain infections (e.g., HIV or tuberculosis), anal

trauma, or low fiber diet may play a role.
PREVENTIVE MEASURES

• Avoid constipation by:

- Drinking at least 8 glasses of water daily.

- Eating a diet high in fiber.

- Using stool softeners, if needed.

• Don’t strain when having a bowel movement.

• Avoid anal trauma.
EXPECTED OUTCOMES

Most fissures heal on their own. Others can be treated

successfully. Most infants and young children recover

after the stool is softened.
POSSIBLE COMPLICATIONS

Fissure may become chronic and fail to heal.

DIAGNOSIS & TREATMENT

GENERAL MEASURES

• Your health care provider will do a physical exam of

the anus and rectum to confirm the diagnosis. Other

medical tests are usually not needed.

• Treatment usually begins with self-care. Conservative

therapy is safe, has few side effects, and is usually the

first step in therapy. The next steps may involve prescribed

topical drugs or botulinum injection, and

surgery if needed.

• Gently clean the anus with soap and water after each

bowel movement.

• To relieve muscle spasms and pain around the anus,

apply a warm towel to the area.

• Sitz baths also relieve pain. Use 8 inches of warm

water in the bathtub, 2 or 3 times a day for 10 to 20

minutes.

• Surgery may be needed in some cases. The options,

and the risks and benefits will be discussed with you.
MEDICATIONS

• For minor discomfort, use nonprescription topical

anesthetics, such as lidocaine gel.

• Use stool softeners (e.g., docusate sodium or

docusate calcium).

• Topical nitroglycerin may be prescribed. It can cause

headache in some patients.

• Topical calcium channel blockers may be prescribed

(e.g., diltiazem or nifedipine). An oral form of the drug

is sometimes prescribed.

• Botulinum toxin (Botox) injections may be prescribed

to help relax the sphincter muscles.
ACTIVITY

No limits. Physical activity reduces constipation risk.

DIET

Eat a high-fiber diet and drink extra fluids to prevent

constipation.
NOTIFY OUR OFFICE IF

• You or your child has symptoms of an anal fissure.

• Pain continues despite treatment.

•Drugs used for treatment cause side effects.
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Contact Info

11109 Surrey Hills Boulevard
Yukon, OK 73099-8155

Phone: (405) 373-2400
Fax: (405) 373-4400

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