An anal fissure is a tear in the anus or anal canal’s lining (mucosa) that causes pain during or after a bowel movement. The tear was most likely caused by a hard bowel movement or passing large stools.

Anal fissures can be incredibly painful, and individuals may suffer from bleeding and spasms while having them.

At first, anal fissures are shallow cuts, but once damaged, those fissures can quickly become more more established, especially if there is further strain on the area. As they age or become chronic (more than eight weeks old), they develop into deeper wounds. Internal or external fleshy growths may also develop around the area. You may feel a burning or tearing sensation when going to the toilet. This feeling is highly uncomfortable. Anal fissures often cause bleeding when you go to the toilet, which can be distressing and embarrassing.

Although anal fissures are painful, they are not life-threatening.

The precise location of the fissure can tell the doctor a lot about the cause. Fissures that emerge from the side of the anal opening rather than the front or rear could be an indication of Crohn’s disease. However, it could be something else. An expert in anal fissures will be able to properly diagnose the issues, as well as ruling out other disorders.

If you have dry constipation or are constantly straining to go, engage in anal intercourse, or force foreign objects into your anus, you may be at high risk for anus/anal fissures. Constipation is the most common cause, which is why doctors recommend good hydration and high fibre diet.

If you have an anal fissure, you may feel uncomfortable for several hours after a bowel movement. You may notice blood on the toilet paper or bright red blood on the stool. You may find a tear, lump, or skin tag near the anus or anal fissure.

Anal fissures or haemorrhoids?

Anal fissures and haemorrhoids can both cause pain, itching, and bleeding. If you are in pain but don’t feel an external lump, the condition is more likely to be a fissure. However, only examination by an appropriately trained doctor or surgeon can provide an accurate diagnosis. Some patients may have a combination of anal fissures with haemorrhoids, sometimes with anal skin tags too, as these can develop after haemorrhoids or fissures where the skin overgrows. Our colorectal surgeon can provide a comprehensive treatment, whatever your needs.

Diagnosing anal fissures

When you visit Cosmedics, your doctor will examine you thoroughly, and especially the anal area. Although the tear is usually quite apparent, the doctor will will also inspect the anus and the interior of the rectum for evidence of any older fissures or other issues. Where required, we may recommend a proctoscopy examination.

We offer a range of non-surgical treatment options for anal fissures:

• We are able to prescribe a cream called Diltiazem which can help to relax the sphincter muscles while the wound heals. This is normally applied two times a day for up to 6 weeks. Diltiazem will help to settle mild to moderate anal fissures.
• In more severe cases, we can also administer Botox injections into the area. This is completely pain-free. This safe and harmless procedure can have up to 80% cure rate.

Both the above are swift and simple procedures that are carried out while you’re awake.