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Anal Fissures

Anal fissures are painful tears in the anus that can cause bleeding and discomfort during bowel movements. At GastroDoxs in Houston, board-certified gastroenterologist Dr. Bharat Pothuri offers expert diagnosis and personalized, effective treatments to soothe pain and promote lasting healing.

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Bharat Pothuri

About the Expert

Dr. Bharat Pothuri is a board-certified gastroenterologist and the founder of GastroDoxs. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

What Are Anal Fissures?

An anal fissure is a small tear or crack in the lining of the anus. It often causes sharp pain and bright red bleeding during bowel movements.

Common Causes and Risk Factors

  • Hard or large stools due to chronic constipation
  • Frequent diarrhea irritating the anal skin
  • Straining during bowel movements
  • Trauma from childbirth or other anal injuries
  • Inflammatory conditions such as Crohn's disease

Signs and Symptoms

  • Sharp, burning pain during and after bowel movements
  • Bright red blood on toilet paper or in the stool
  • Visible tear or crack near the anal opening
  • Itching or irritation around the fissure
  • Formation of a small lump or skin tag at the tear

Expert Treatment for Anal Fissures by Dr. Bharat Pothuri

Dr. Pothuri uses a step-by-step approach:

Medical History and Physical Exam

He reviews your symptoms-pain, bleeding, bowel habits-and asks about risk factors such as chronic constipation, diarrhea, childbirth or prior anorectal issues.

Visual Inspection and Digital Palpation

A careful external exam checks for visible cracks, skin tags or signs of spasm. A gentle digital rectal exam evaluates sphincter tone and locates the fissure.

Anoscopy

Using a low-pressure anoscope, he inspects the anal canal lining directly to confirm the fissure, assess its depth and rule out other conditions like hemorrhoids or tumors.

Advanced Testing (if needed)

  • Anal manometry to measure resting sphincter pressure when muscle spasm is suspected.
  • Endoanal ultrasound to evaluate sphincter integrity in chronic or recurrent cases.
Bharat Pothuri
Treatment

Our Team offers a full range of care for anal fissures.

1. Lifestyle and Diet Changes

  • Drink plenty of water to soften stools
  • Use fiber supplements such as psyllium powder
  • Eat more fruits, vegetables, and whole grains
  • Take your time during bathroom visits; avoid rushing
  • Use warm sitz baths two to three times daily

2. Medications

  • Topical nitroglycerin or calcium channel blockers to relax the anal muscles
  • Stool softeners or mild laxatives to prevent straining
  • Over-the-counter pain relievers or prescription creams for discomfort

3. Minimally Invasive or Advanced Procedures

  • Botox injections to relieve muscle spasms
  • Lateral internal sphincterotomy to reduce pressure and promote healing
498

Patients Treated

Dr. Pothuri has treated more than 498 patients, helping individuals improve their digestive health and overall well-being through expert, personalized care.

20Y

Years of Experience

With over 20 years of experience, GastroDoxs has been a trusted provider of gastroenterology care, focusing on delivering the best outcomes for patients

Bharat Pothuri

About the Author

Dr. Bharat Pothuri is a Board-Certified Gastroenterologist and Hepatologist. With extensive experience in digestive health, he specializes in advanced endoscopic procedures, chronic GI disorder management, and preventive care. Dr. Pothuri is dedicated to providing expert, patient-focused insights to help improve gut health and overall well-being.

Frequently Asked Questions

Can anal fissures heal without treatment?

Mild fissures often heal with diet changes and sitz baths. See a doctor if pain or bleeding lasts more than two weeks.

Are fissures related to hemorrhoids?

Yes. Both can cause pain and bleeding, but treatments may differ. Dr. Pothuri checks for both conditions and tailors your care accordingly.

Why do fissures itch after healing?

Itching occurs as new skin grows. Gentle cleaning, warm sitz baths, and fragrance-free creams help relieve irritation.

When do fiber supplements start working?

Most patients notice softer stools and easier bowel movements within 3-5 days of starting supplements like psyllium.

Is surgery the only option for persistent fissures?

No. Chronic fissures often respond to Botox injections. Surgery (lateral internal sphincterotomy) is reserved for cases unresponsive to other treatments.

Can pregnant women get anal fissures?

Yes. Hormonal changes and childbirth increase risk. Dr. Pothuri offers safe, effective treatments for expectant mothers.

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