Anal Fissure

An anal fissure is a tear or sore that develops in the anal canal, the final part of the back passage.

It is a very common condition that causes pain or bleeding, especially during bowel movements. It usually occurs after passing hard stools. Chronic constipation, obstructed defecation syndrome, chronic diarrhea and childbirth can also cause an anal fissure. The tear causes severe pain, particularly during bowel movements, and this pain can last for a long time. Patients often describe it as feeling like being cut by glass. The pain triggers a spasm in the surrounding muscles, which reduces blood flow and can result in a wound that does not heal.

Most acute fissures heal on their own or with simple treatments prescribed by your doctor.

These treatments mainly aim to relieve pain, prevent hard stools and ease the spasm.

In some patients, however, the condition progresses and becomes chronic.

For chronic fissures, the goals are to adjust the diet, increase water and fiber intake, reduce pain and spasm with various creams and/or medications, and improve blood flow to the area.

When these treatments fail, Botox injection or surgery may be needed. The most suitable treatment should be chosen for each patient, taking into account their age, sex, other medical conditions, previous treatments and any prior surgery, as well as the strength of the anal muscles.