Anal fissures are small tears in the lining of the anus. They can cause sharp pain during or after a bowel movement and may bleed slightly, making bathroom trips very uncomfortable.
People with anal fissures often notice:
Anal fissures most commonly result from:
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Many acute anal fissures heal within 4-6 weeks with simple home care measures such as stool softeners, a high-fiber diet, adequate hydration, and warm sitz baths.
Anal fissures typically cause sharp, stabbing pain and may show a visible tear in the lining of the anus. Hemorrhoids feel like swollen veins that can bulge, itch, or protrude and may not cause as intense pain during bowel movements.
An anal fissure is a small crack or tear in the anal lining, whereas hemorrhoids are swollen blood vessels inside or outside the anus. Their symptoms and treatments can differ significantly.
Yes. Straining during bowel movements or chronic irritation can lead to both hemorrhoids and anal fissures occurring at the same time.
Bright red blood on the surface of your stool or on toilet paper usually indicates an anal fissure. Hemorrhoid bleeding may also appear bright red but is often accompanied by itching, swelling, or protrusion.
Surgery, such as lateral internal sphincterotomy, is typically reserved for chronic fissures that do not heal after several weeks of topical treatments (nitrates, calcium channel blockers), sitz baths, or Botox injections.
Bulk-forming agents like psyllium and osmotic laxatives (e.g., polyethylene glycol) are often recommended to ensure soft, easy-to-pass stools and reduce strain on the fissure.
Your gastroenterologist may begin with a topical nitroglycerin ointment or a calcium channel blocker such as diltiazem to relax the anal sphincter and promote healing.
Lateral internal sphincterotomy involves making a small incision in the internal anal sphincter muscle to reduce resting pressure, improve blood flow to the area, and allow the fissure to heal.
Prevention strategies include eating a fiber-rich diet, staying well hydrated, avoiding straining during bowel movements, using stool softeners as needed, and taking regular warm sitz baths after bowel movements.
