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Anal Fissure

An anal fissure is a split in the mucosa (or lining) of the anus. It is very common in children under the age of one year and in fact, 80% of babies suffer from this condition. It is also common in adults, with around 0.3% of the population suffering anal fissures, mainly in the 15-40 age range.

The split or tear normally has a physical cause and is often the result of constipation. Hard stools may cause damage to the anal region and the resultant split can develop into an ulcer and the chances are that the region may get infected. Anal fissures are generally quite painful and can also cause bleeding from the anus during a bowel movement.

Besides constipation, anal fissures can also be caused by the following factors:

  • Diarrhea
  • Other trauma to the anal area
  • Inflammation of the anal area (this can be caused even by roughly wiping after going to the toilet)
  • Pregnancy/childbirth
  • Crohn's Disease
  • Ulcerative Colitis
  • Cancer of the rectum

The method prescribed for treating anal fissures largely depends on the type and severity of the condition.  Anal fissures vary widely - they can be very small and almost invisible to the naked eye. In this case, they generally heal quickly without treatment. 

Anal fissures can grow larger and can get associated with the anal sphincter muscle developing a spasm, which in turn restricts blood supply to the area and makes the development of ulceration and an infection more likely.

About Treating Anal Fissures

The main causes of anal fissures are constipation and diarrhea, and if these are treated promptly, the chance of developing anal fissures is minimized. Also, good hygiene practice can help to prevent or improve the condition. Practices, like using soft paper/wet wipes and not being too rough when cleaning, frequent nappy changing in babies, can minimize the problem.

Ointments such as petroleum jelly can be used. Cream for haemorrhoids is not advised for treating anal fissures as it restricts blood flow and can worsen the condition. 'Sitz Baths' that involves shallow warm salt water bath can also help to reduce pain and sanitize the area. Other treatment may involve pain relief, laxatives, anesthetic creams, or Botox injection/nitroglycerin cream to control any muscle spasm.

If preventative and other measures are not effective for treating anal fissures, surgical correction may be necessary. This is generally a day procedure called a 'sphincterotomy' which divides the lower part of the sphincter muscle and stops the muscle from going into spasm. This allows the fissure to heal on its own.

If anal fissures are not treated promptly they may cause other problems such as anal fistula (link) or anal stenosis where the anal passage narrows abnormally.

If you notice symptoms of anal fissures, it is necessary to consult a doctor to ensure early diagnosis and treatment. If you require consultation for treating anal fissures, feel free to get in touch.

Dr Raaj Chandra consults at Elgar Hill Medical Suites (Box Hill). To book a consultation, call today on (03) 9895 7100.