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Anal Fissure

A condition caused by small tears in the inner lining of the anal canal, leading to severe pain and bleeding during defecation.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Anal Fissure?

Anal fissure is a small but deep tear in the thin mucosal layer of the anal canal. It is usually located on the posterior midline. Acute fissures last less than a few weeks; those lasting more than 6 weeks are considered chronic.

Excessive contraction of the internal anal sphincter muscle (hypertonia) delays healing of the fissure because blood flow to the muscle is reduced. This vicious cycle is the main cause of chronic fissure.

Anal fissures can occur at any age; young adults and infants may be particularly affected. There may be an association between inflammatory bowel diseases such as Crohn's disease and fissures.

Symptoms

Sharp, burning anal pain during defecation
Cramping-type pain that can last for hours after defecation
Bright red blood on toilet paper
Itching in the anal area
Fear of defecating (defecation phobia)
Visible tear or cut in the anal area

Risk Factors

Chronic constipation and hard stools
Bouts of diarrhea
Vaginal delivery (especially difficult labor)
Crohn's disease and other inflammatory bowel diseases
History of anal surgery
Inadequate fiber intake

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If pain during defecation reduces quality of life
  • Symptoms lasting longer than 6 weeks (chronic)
  • Recurrent or non-healing fissure
  • If fever or discharge accompanies (suspected abscess)
  • If there is no response to standard treatment

Treatment Methods

01
Stool softening with high-fiber diet, plenty of fluid intake, and use of laxatives
02
Topical nitroglycerin or calcium channel blocker (diltiazem) cream: relaxing the sphincter muscle to increase blood flow
03
Botulinum toxin injection: temporarily paralyzing the internal anal sphincter to enable healing
04
Lateral internal sphincterotomy (LIS): surgical cutting of a portion of the internal sphincter muscle (gold standard in chronic resistant cases)
05
Anal dilation (less preferred in current guidelines)
06
Disease-specific treatment in Crohn-related fissures

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.