Anal Fissures Symptoms Causes And Treatment Options
Informed by recognized medical guidance
Overview
An anal fissure is a small tear in the thin, moist lining of the anus (the opening where stool leaves the body). It can cause pain and bleeding during and after bowel movements. Most fissures heal with simple care, though some can become long-lasting.
Key facts
- Anal fissures are common and affect people of all ages.
- They are not a form of cancer and are not contagious.
- Most heal within a few weeks with self-care and stool softening.
- If a fissure lasts more than six to eight weeks, it is called a chronic fissure.
Yes, anal fissures are very common. Many people experience at least one at some point in life.
Anyone can get an anal fissure. They are especially common in infants and young children, and in adults between 20 and 50 years old. They also occur often in older adults, particularly those with constipation.
Symptoms
- Call your local emergency number if you have heavy bleeding from the rectum that soaks through clothing.
- Call your local emergency number if you feel faint, dizzy, or have a rapid heartbeat with bleeding.
- Call your local emergency number if you are passing large amounts of blood, clots, or dark black stool.
- ⚠Contact your doctor or local health service if you have severe pain that does not improve with home care.
- ⚠Contact your doctor or local health service if bleeding lasts longer than a few days.
- ⚠Contact your doctor or local health service if you have signs of infection such as fever, chills, or foul-smelling discharge.
Common symptoms
- Sharp pain during a bowel movement that can last for hours afterward
- Bright red blood on the toilet paper or on the surface of the stool
- A visible tear or crack in the skin around the anus
- Itching or burning around the anus
- A feeling of tightness or spasms in the anal muscles
Symptoms in children
- Crying or showing signs of pain when passing stool
- Holding in stool to avoid pain, which makes constipation worse
- Blood on the diaper or toilet paper
- A small tear that can be seen when gently wiping
Symptoms in older adults
- Pain that may be less intense but still noticeable
- Bleeding during bowel movements
- Difficulty cleaning the area or a feeling of soreness
- Symptoms that might be mistaken for other conditions, so a doctor's check is important
Causes
Main causes
- Passing hard or large stool that stretches or tears the anal lining
- Chronic diarrhea that irritates the area
- Straining during bowel movements
- Childbirth for some women
- Prolonged sitting on the toilet or holding in a bowel movement
Risk factors
- Constipation or frequent hard stools
- Low-fiber diet and not drinking enough fluids
- History of constipation as a child or older adult
- Anal sex or other forms of anal trauma
- Certain digestive conditions that cause frequent loose stools
When to see a doctor
See a doctor urgently if:
- You have heavy bleeding or bleeding with dizziness
- You have a fever along with pain or swelling
- You cannot sit or eat because of the pain
Book a routine appointment if:
- You have mild symptoms that have not improved after 4 to 6 weeks
- You see blood on the toilet paper more than twice
- You have repeated anal fissures
- You are unsure about the cause of your symptoms
Diagnosis
A doctor can usually diagnose an anal fissure by listening to your symptoms and gently examining the area around the anus. The exam is brief and often causes little discomfort.
Tests that may be done
- A visual inspection of the anal area
- A gentle digital rectal exam with a gloved finger
- An anoscopy, which uses a small lighted tube to look inside the anal canal (if needed)
What to expect at your appointment
You will be asked about your bowel habits, diet, and any pain or bleeding. The doctor may ask you to lie on your side with your knees bent. They will examine the area and talk with you about a treatment plan. You can ask questions at any time.
Treatment
Most anal fissures heal with simple measures that soften the stool and relax the anal muscles. The goal is to prevent further tearing and give the skin time to heal. If a fissure persists, there are additional medical options.
Self-care at home
- Take warm sitz baths (soaking in plain warm water for 10 to 15 minutes) several times a day, especially after bowel movements
- Drink plenty of fluids, especially water, to keep stool soft
- Eat more high-fiber foods such as fruits, vegetables, and whole grains
- Avoid straining on the toilet and do not delay bowel movements
- Use gentle wiping, such as moist wipes or water, instead of dry toilet paper
Medical treatments
If self-care is not enough, a doctor may recommend stool-softening medicines, topical creams or ointments that help relax the anal muscles, or other approaches. Some procedures can be done in the doctor's office to encourage healing. Your doctor will choose what is best for you.
When is surgery considered?
If a fissure does not heal after several weeks of treatment, a small surgical procedure may be recommended to relax the anal muscle and improve blood flow. Surgery is safe and effective for most chronic fissures.
Living with this condition
Living with an anal fissure can be uncomfortable, but small habits can make a big difference. Keep a regular toilet routine, do not hold in stool, and gently clean and dry the area after each bowel movement.
Lifestyle tips
- Take regular walks or gentle exercise to support healthy digestion
- Set a regular time to sit on the toilet, such as after meals
- Use a footstool to bring your knees slightly up while on the toilet, which helps stool pass more easily
- Wear comfortable cotton underwear that allows the area to breathe
Diet and exercise
A diet rich in fiber and plenty of water are the best ways to prevent the hard stools that cause fissures. Aim for gradual changes to avoid bloating. Regular physical activity helps keep bowel movements regular and reduces pressure on the pelvic area.
Mental health and emotional wellbeing
The pain and worry of an anal fissure can be stressful. It is normal to feel anxious about using the toilet. Remember that this condition is treatable, and talking openly with a doctor or a trusted person can help.
Prevention
Many anal fissures can be prevented by keeping stool soft and regular. Drinking enough water, eating fiber, exercising, and not delaying toilet trips are the best preventions.
Complications
If left untreated
- A fissure that lasts longer than eight weeks and becomes chronic
- Pain that interferes with daily life or sleep
- An anal fistula, an abnormal tunnel that forms when an infection drains
- Severe bleeding or signs of infection
Long-term outlook
Most anal fissures heal quickly with simple care. Even when a fissure becomes chronic, effective treatments are available. With patience and the right support, nearly everyone can find relief.
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: August 1, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.