What is an anal fissure?

An anal fissure is a tear in the skin lining of the anus or the anal canal that results in bleeding and pain. Fissures can develop into further problems if not cared for and treated properly.


The most common symptom associated with an anal fissure is pain both during and after passing a stool. This process may also involve the presence of bleeding that occurs when a stool is passed.
Other possible symptoms may include:
  • The presence of bright red blood on stool and toilet paper following a bowel movement
  • Pain, both during and after a bowel movement
  • Redness, irritation and itching around the anus
  • Noticeable cracks around the skin of the anus
  • Small lump on the skin near the anal fissure

Causes and Risk Factors

Any of the following may result in an anal fissure, but the most common cause is trauma around the anus or anal canal.
  • Chronic constipation and difficulty with bowel movements
  • Anal sexual contact, anal stretching
  • Straining during bowel movements
  • Prolonged bouts with diarrhea
  • Inflammation of the anorectal area, caused by inflammatory bowel disease or Crohn’s disease

Diagnostics Tests

A doctor who specializes in the treatment of anal fissures can usually diagnose the condition by visual inspection of the anus. The following exams are typically conducted to aid in proper diagnosis:
  • Visual inspection of the anus
  • Gentle examination via fingertip to inspect the anus for trauma

Treatment and Procedures

The treatment plan may vary depending on the severity of the condition. Most anal fissures do not require surgery and treatments may include:
  • Warm sitz baths several times a day
  • Administration of stool softeners and fluids to relieve constipation
In the event that the common treatments are unsuccessful or the anal fissures recur, surgery may be recommended. Surgery treatment for anal fissures is usually performed on an outpatient basis.

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