Anal Fissure
An anal fissure is a small tear in the lining of the anus, often related to passing hard stool.
About anal fissure
An anal fissure is a small tear in the lining of the anus, often related to passing hard stool.
What can cause it?
Anal fissures often follow passage of a hard or large stool, constipation, prolonged diarrhea, or childbirth.
Inflammatory bowel disease, infection, or another disorder may be considered when fissures are recurrent or in an unusual location.
What a patient may notice
Symptoms vary from person to person. Possible signs may include:
- Sharp pain during or after a bowel movement
- Small amount of bright red blood
- A visible crack or irritation near the anus
How clinicians find the cause
Diagnosis is usually made from the symptom pattern and careful visual examination. Further testing may be needed when bleeding is recurrent, the fissure does not heal, or another bowel condition is suspected.
Treatment and next steps
- 1
Treatment aims to keep stools soft and relax the anal muscle so the tear can heal.
- 2
A clinician may recommend fiber, fluids, stool-softening treatment, warm baths, prescription ointment, or referral for a procedure.
- 3
Ongoing bleeding should not automatically be attributed to a fissure without evaluation.
Supporting recovery
- Avoid straining and do not delay the urge to have a bowel movement.
- Increase fiber and fluids gradually if medically appropriate.
- Warm sitz baths may ease discomfort.
What to expect
Most recent anal fissures heal with softer stools, warm baths, and appropriate treatment. Healing may take longer when the fissure has become chronic or the anal muscle remains tight. A person who has had one fissure is more likely to develop another, especially if constipation or diarrhea returns.
Possible complications
- A chronic fissure with continuing pain or bleeding
- A cycle of avoiding bowel movements, harder stool, and repeated tearing
- Recurrence or the need for prescription treatment or a procedure when conservative care does not work
When to Contact a Medical Professional
Arrange an evaluation when symptoms are new, worsening, interfering with normal activities, or not improving as expected.
Heavy bleeding, black stool, fainting, fever, or severe worsening pain needs urgent evaluation.Get emergency help for severe trouble breathing, new chest pressure, fainting, seizure, sudden weakness on one side, uncontrolled bleeding, blue or gray lips, or a person who is difficult to wake.
Ways to lower risk
- Maintain regular soft stools with diet, hydration, activity, and clinician-guided treatment when needed.
- Address chronic diarrhea or constipation early.
Trusted health information
This CHS patient-education page uses original wording and links to MedlinePlus for additional information.