An anal fissure is a tear or a break in the lining of the anal canal, where stool passes out of the body. They are painful and may bleed, causing so much discomfort that they can affect your quality of life.
Many anal fissures heal on their own or with the assistance of things like dietary changes and home remedies. However, deeper fissures that persist may require treatment from a healthcare provider.
This article explains the more common symptoms and causes of anal fissures. It also offers ideas on how to treat fissures yourself, as well as how to prevent them from coming back.
Anal Fissure Symptoms
Anal fissures happen when there has been some type of injury to the anal canal. This trauma to the anal lining is what leads to symptoms such as:
DiscomfortItchingPain with bowel movementsBleeding
Causes
Tears in the anal canal can happen to anyone, but they’re more common in people who are younger and appear to be otherwise healthy. Uncomplicated fissures are called primary fissures.
This is true even if you’ve had fissures in the past and know the signs. This is to be sure that you actually do have an anal fissure and not another more serious concern.
A fissure could be caused by diarrhea or constipation. In the past, it was thought that most fissures were related to a person straining to pass stool. However, it’s now known that unusually tense muscles of the anal sphincter may be the actual cause—especially for chronic (long-term) cases. Too much tension can lead to a fissure, which in turn leads to pain, spasms, and more tension. This creates an ongoing cycle.
In addition to this, anal fissures can sometimes occur during childbirth, especially after a delivery that was difficult or one that was instrument-assisted.
Some other conditions associated with primary anal fissures include:
Hypothyroidism Obesity Tumors (although, they are an uncommon cause)
The fissures are called secondary when they occur along with another condition. These conditions include Crohn’s disease and ulcerative colitis, both forms of inflammatory bowel disease (IBD). Other medical issues that are associated with anal fissures are:
Tuberculosis Sarcoidosis HIV/AIDS Syphilis
Fissures that occur in the context of these diseases, other conditions, or infections may become chronic. They will usually take longer to heal and often require surgery or other intervention.
Home Remedies for Anal Fissures
Anal fissures are painful, in part, because people who have them still need to move their bowels while they’re healing.
It is important to keep stools soft and make it easier for them to pass out of the body, so the fissure is not further irritated by bulk or straining.
There are other self-care measures that may help reduce the pain of anal fissures while allowing them to heal more quickly.
Treatment at home for uncomplicated anal fissures can include eating more fiber, using stool softeners, and drinking more water. These options also may include using sitz baths and a local anesthetic to decrease pain.
Sitz Baths
Sitz baths, available at most drugstores, are essentially small plastic tubs. You fill the tub with a few inches of warm water, place it atop a toilet seat, then sit on it, allowing your anal area to soak in the water.
Doing this for about 10 to 15 minutes at a time can help ease pain and other symptoms in the anal area, though it may not do much to speed the healing of the fissure.
In some cases, Epsom salts or other products may be added to the water in the sitz bath. However, these should only be used with a healthcare provider’s approval.
You can use your bathtub if you don’t have access to a plastic sitz bath. If you do, be sure to clean your bathtub well before your sitz soak and keep to the recommended soaking time.
Dietary Fiber
The Academy of Nutrition and Dietetics recommends that adult males and females get at least 38 grams (g) and 25 g of fiber per day, respectively. However, many adults in the United States do not regularly achieve this goal.
Eating the right amount of fiber helps prevent stools from being too hard and causing constipation. It also keeps stools from being too liquidy and causing diarrhea.
A soft, easily passed stool will be less hard on the fissure and keep it from getting even more irritated.
You’ll want to start slowly with fiber supplements and increase the amount used over time. This will help you avoid side effects like abdominal bloating and gas.
It may take some trial and error to understand which fiber supplement at what dosage is the “right” one for you.
Stool Softeners
A stool softener may help you to avoid constipation by pulling more water into the digestive tract to soften stool. They are associated with few side effects and are generally considered safe. Stool softeners are not the same as laxatives.
Stool softeners come in liquid, capsule, and tablet forms. Most people usually use them for about a week.
Other lifestyle changes should be put in place to help with constipation, too. This is so you can eventually stop using the stool softeners.
Check with a healthcare provider about which over-the-counter stool softener treats anal fissures most effectively.
Drinking More Water
Dehydration, or not having enough water in your body, can contribute to constipation. Drinking water can help keep stools soft and make them easier to pass.
Foods with a lot of water in them, like fruits and vegetables, also add to your overall water intake.
That said, it may be that your own body is the best gauge for how much water you need. When stools are soft and easily passed, it may mean that you have enough overall water in your diet.
Caring for Perianal Skin
Keeping clean after bowel movements can be a challenge when you have a fissure. If wiping is causing pain, try using a bidet or a hand shower. It may be gentler on your irritated skin.
Instead of toilet paper, you may want to try gentle, fragrance-free wet wipes. These may work, but remember not to flush them so they don’t clog up your plumbing.
Softer flannel washcloths may help too, for those that don’t mind doing a bit of laundry.
Preventing Anal Fissures
If you’re prone to getting anal fissures, prevention is key. The measures used to treat an anal fissure may help in preventing one as well:
Avoid straining during bowel movements. Try to consciously relax the muscles in the anal canal during a bowel movement. This can help you to avoid the increase in sphincter tone that may lead to fissures. Go to the bathroom when you feel the urge. Holding on to a bowel movement for a long period can mean that it becomes harder to pass. Avoid this. Ask your healthcare provider about bowel retraining. This involves going to the bathroom on a schedule in an effort to get the body to have regular bowel movements. This may particularly help those who live with bowel conditions, like chronic constipation or related irritable bowel syndrome (IBS).
Summary
Many anal fissures can be treated effectively at home. This is likely the case when they occur because of constipation or diarrhea, rather than being caused by an underlying medical condition. It’s important to treat fissures and their causes before they become chronic and are harder to heal.
Some of the home remedies you might want to try to treat anal fissures also may help to prevent them in the future. Drinking more water and choosing foods with more fiber and water content will help to make your stools softer. Passing stools more easily will reduce the discomfort that comes with fissures. Stool softeners can help as well.
A Word From Verywell
Anal fissures are painful and can impact your quality of life. The good news is that most fissures will heal on their own at home. The key is to reduce the discomfort while promoting healing in the area.
Still, treating fissures should always be done with the help of a healthcare provider. This will give you the best chance of healing without any long-term problems or having the fissure become chronic. It also will ensure that you’re not overlooking a different, more serious condition.
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