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This Health Facts for You discusses treatment for an anal fissure.
An anal fissure is a small tear or cut in the skin lining the anus. Symptoms include:
Extreme pain during bowel movements
Red blood, bleeding with bowel movements
Spasms of the anal muscles
Causes of Anal Fissures
Hard, dry bowel movements
Diarrhea
Inflammation
Trauma to the anus
Once a cut forms, it causes the muscle around the anal opening (sphincter) to spasm. These spasms make it hard for the cut to heal and can cause pain to last for some time after a bowel movement.
Treatment
An acute fissure (new onset) is treated without surgery. With improving bowel habits, the fissure may heal on its own. These changes include:
Eating a high fiber diet
Drinking more water
Taking stool softeners
Taking a bulk fiber such as Metamucil
These changes allow you to pass soft stool and avoid constipation.
Take warm baths for 10-20 minutes several times a day to sooth and relax the anal muscles. Your doctor may also give you creams to help.
Types of Surgery
A chronic fissure (lasting more than a month or one that heals and comes back) may require surgery.
There are two types of surgery.
Sphincterotomy: Your surgeon creates a minor cut of the internal anal sphincter muscle. This treatment helps the fissure to heal by relaxing the sphincter and decreasing spasms.
Injections: The other type of surgery involves injecting Botox, or a muscle relaxer, into the sphincter muscle to decrease the spasms.
After Surgery
It may take a few weeks for the fissure to completely heal. You will likely have less pain within a few days.
Take a sitz bath at least 3-4 times a day and after each bowel movement. A sitz bath is sitting in a bathtub of warm water for 10-20 minutes. This will help decrease the pain of muscle spasms and help you heal.
You may be told to take a stool softener (docusate sodium) and/or a bulk fiber laxative such as Metamucil. Both prevent constipation. You can buy these without a prescription.
Please contact the clinic before resuming or starting any new creams near the surgical area. Activities
Change your position from sitting to standing to lying down for comfort.
You may return to work when you feel ready.
No driving while taking prescription pain pills.
You may resume sex when you feel ready.
Follow Up
You will return to the clinic in 1-3 weeks.
When to Call
Call the clinic if you notice:
Large amount of bright red blood that does not stop with pressure to the area for 10 minutes
Fever over 100.4 F for 2 readings, taken 4 hours apart. Check for a fever once daily at the same time each day for a week
Foul-smelling drainage
Excess swelling
You cannot control bowel movements
Trouble passing urine
Who to Call
Digestive Health Center
(608) 242-2800
After hours, weekends, or holidays ask for the doctor on call. Leave your name and phone number with area code. We will call you back.
Toll-free number:855-342-9900