An anal fissure is a cut or tear in the lining of the anus. The anus is the opening through which stool leaves the body. Tears generally occur just inside the opening.
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The exact cause of an anal fissure is unknown. In most cases, tearing is the result of trauma to the anal lining. Trauma can be caused by:
Factors that may increase your chance an anal fissure include:
Anal fissure may cause:
Apprehension about bowel movement pain may cause you to delay bowel movements. This can make the symptom worse.
The doctor will ask about your symptoms and medical history. A physical exam will be done. Anal fissures are generally visible, so diagnosis can be made with an anal exam. If it is not visible, but suspected, your doctor may need to do other tests as long as it is not too painful. These tests include:
Fissures usually occur in predictable locations around the anus. If there are multiple cuts, or a cut in an unusual location, the doctor may order additional tests to look for other conditions.
Treatment aims to heal the cut and prevent future anal problems. Most fissures heal on their own or with self-care. Fissures that are fairly new are easier to heal than ones that have persisted for longer than 3 months.
Fissures may heal by changing some of your daily habits. These include:
Your doctor may prescribe:
Surgery may be necessary for:
Surgical procedures include:
To help reduce the chance of an anal fissure:
American College of Gastroenterology
American Society of Colon and Rectal Surgeons
Canadian Association of Gastroenterology
Canadian Society of Colon and Rectal Surgeons
Anal fissure. American Society of Colon & Rectal Surgeons website. Available at: http://www.fascrs.org/patients/disease-condition/anal-fissure. Updated October 2012. Accessed November 9, 2015.
Anal fissure. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated July 9, 2015. Accessed November 9, 2015.
Fargo M, Latimer K. Evaluation and management of common anorectal conditions. Am Fam Physician. 2012;85(6):624-630.
Last reviewed November 2015 by Michael Woods, MD