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:
Digital rectal exam—to feel for any lumps or abnormalities
Anoscopy—examination of the anal canal with a scope
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:
Warm sitz baths, especially after bowel movements, to help relieve pain and promote healing
Increasing dietary fiber intake
Increasing fluid intake
Using stool softeners or bulk laxatives
Your doctor may prescribe:
Topical medications to reduce pain and inflammation
Topical nitrates and calcium channel blockers to increase blood flow to the anus and promote healing
Injected botulinum toxin to relax tightened anal sphincter muscles
Anal fissure expanded innformation. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/abscess-and-fistula-expanded-information. Accessed December 18, 2017.