Anal Fissure

What is an Anal Fissure?

An anal fissure is a small tear in the lining of the anal canal. Anal fissures are common in infants between 6 and 24 months. Anal fissures are less likely to develop in older children.

What causes Anal Fissures?

Anal fissures may develop in adults from passing hard or large stools during bowel movements. Anal fissures are also caused by:

• Large or hard stool passing through the anal canal
• Constipation and straining during bowel movements
• Inflammation of the anorectal area, such as is caused by inflammatory bowel disease
• Anal sex

Symptons of an Anal Fissure

The most common symptoms of an anal fissure are:

• Pain or burning during bowel movements that eases until the next bowel movement
• Bright red blood on the outside of the stool or on toilet paper or wipes after a bowel movement
• Itching or irritation around the anus
• A visible crack in the skin around the anus

When to see a doctor

If you think you have an anal fissure, you should see a doctor. It is especially important to see a doctor if you have pain during bowel movements or blood on stools or toilet paper after a bowel movement.

Treatments for Anal Fissures

Topical cremes or suppositories can be used to to help reduce inflammation and provide relief while the anal fissures heal. About 90 percent of anal fissures heal without surgery. If you develop an anal fissure that doesn't heal, surgery may relieve your discomfort. Surgery usually involves cutting a portion of the anal sphincter muscle. Surgery may also include removal of the fissure and any scar tissue resulting from it. Anal fissures that fail to heal may become chronic and cause considerable discomfort.

The most common risk factors for developing anal fissures:

• Infancy. Many infants experience an anal fissure during their first year of life, although experts aren't sure of the reason.
• Old age. Older adults may develop an anal fissure. This occurs partly because of slowed circulation. Slowed circulation causes, decreased blood flow to the rectal area.
• Constipation. Straining during bowel movements and passing hard stools increase the risk of anal tearing.
• Childbirth. Anal fissures are more common in women after they give birth.
• Crohn's disease. Crohn's disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.

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