Anal Fissure Overview
Learn About Anal Fissure
An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).
Fissure in ano; Anorectal fissure; Anal ulcer
Anal fissures are very common in infants, but they may occur at any age.
In adults, fissures may be caused by passing large, hard stools, or having diarrhea for a long time. Other factors may include:
- Decreased blood flow to the area
- Too much tension in the sphincter muscles that control the anus
The condition affects males and females equally. Anal fissures are also common in women after childbirth and in people with Crohn disease.
An anal fissure can be seen as a crack in the anal skin when the area is stretched slightly. The fissure is almost always in the middle. Anal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet paper (or baby wipes) after a bowel movement.
Symptoms may begin suddenly or develop slowly over time.
Most fissures heal on their own and do not need treatment.
To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently.
CHILDREN AND ADULTS
Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make the anal fissure worse.
Prevent hard stools and constipation by:
- Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains
- Drinking more fluids
- Using stool softeners
Ask your provider about the following ointments or creams to help soothe the affected skin:
- Numbing cream, if pain interferes with normal bowel movements
- Petroleum jelly
- Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products
A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day for 10 to 15 minutes each time. The water should cover only the hips and buttocks.
If the anal fissures do not go away with home care methods, treatment may involve:
- Botulinum toxin injections into the muscle in the anus (anal sphincter)
- Minor surgery to relax the anal muscle
- Prescription creams, such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles
UCLA Associated General Surgeons
Anne Lin is a Colorectal Surgeon and a General Surgeon in Los Angeles, California. Dr. Lin and is rated as a Distinguished provider by MediFind in the treatment of Anal Fissure. Her top areas of expertise are Anal Fissure, Anal Cancer, Familial Colorectal Cancer, Hernia Surgery, and Colostomy.
Petar Vukasin M D Inc
Petar Vukasin is a Colorectal Surgeon and a General Surgeon in Glendale, California. Dr. Vukasin and is rated as a Distinguished provider by MediFind in the treatment of Anal Fissure. His top areas of expertise are Anal Fissure, Proctitis, Genital Warts, Hemorrhoids, and Hernia Surgery.
Karen Zaghiyan is a General Surgeon and a Colorectal Surgeon in West Hollywood, California. Dr. Zaghiyan and is rated as a Distinguished provider by MediFind in the treatment of Anal Fissure. Her top areas of expertise are Crohn's Disease, Viral Gastroenteritis, Anal Fissure, Ileostomy, and Hemorrhoidectomy.
Anal fissures often heal quickly without any more problems.
People who develop fissures once are more likely to have them in the future.
Summary: This clinical trial is being conducted by investigators who are colorectal surgeons. Eligible study participants will receive the experimental treatment E-CEL UVEC cells by direct injection into the anal fissure. The study is being conducted to determine if E-CEL UVEC cell injections will be safe and would have any effects on healing of the anal fissure.
Summary: No study to date has compared topical DTZ to MEBO ointment in the treatment of anal fissure. Therefore, the present study aims to compare the efficacy and safety of DTZ to MEBO in the treatment of acute anal fissure. The investigators propose to conduct a comparative randomized clinical study. In this study, the investigators will compare patients with acute anal fissure receiving MEBO ointment vs...
Published Date: May 29, 2024
Published By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Hyman N, Umanskiy K. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 53.
Kliegman RM, St. Geme JW, Blum NJ, et al. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 392.