Some fissures can be minimally symptomatic, but most patients present with severe pain, bleeding, or itching. The pain can be localized to the anus but can radiate to the buttocks, upper posterior thighs, or lower back. Often the pain is triggered by a bowel movement, can last for hours, and can be severe.
Most people will fully heal within 2 to 4 weeks.
Sitting can be quite painful with an anal fissure. You may see a few drops of blood in the toilet bowel or when wiping.
The exposed internal sphincter muscle beneath the tear goes into spasm. This causes severe pain. The spasm also pulls the edges of the fissure apart, making it difficult for your wound to heal. The spasm then leads to further tearing of the mucosa when you have bowel movements.
It is often described as feeling like passing broken glass. Typical anal fissure symptoms are a sensation of tearing, ripping or burning and usually a small amount of bright red bleeding during and after a bowel movement. While the condition can be very painful, it is not usually serious.
Quite commonly, anal fissures are misdiagnosed as hemorrhoids by the patient or the primary care physician due to some similar symptoms between the two. This delay in diagnosis may lead to an acute fissure becoming a chronic one and, thus, becomes more difficult to treat.
Anal fissures are typically painful, with sufferers often describing the pain as 'sharp' and the passing of a bowel movement like 'passing glass'. Sometimes the pain is experienced mainly after the bowel movement has passed (often described as 'throbbing') and can last for hours.
The most common symptoms of anal fissures are: a sharp pain when you poo, often followed by a deep burning pain that may last several hours. bleeding when you poo – most people notice a small amount of bright red blood either in their poo or on the toilet paper.
An anal fissure that fails to heal within eight weeks is considered chronic and may need further treatment.
The symptoms of a fissure and a hemorrhoid can be similar. Either can cause pain, itching and bleeding. However, if you are in pain and don't feel an external lump, the condition is more likely to be a fissure. If you notice that you are leaking mucus from your anus, the problem is probably a hemorrhoid.
Alleviate the pain associated with the anal area by sitting on a soft or gel-filled pillow. “But avoid doughnut-shaped pillows,” cautions Gerken, “because they may restrict blood flow to the area.”
Walking promotes overall good health. It lowers the chances of formation of hard stools and stimulates and promotes blood flow which is helpful if you have a fissure.
If someone has a chronic fissure, it is thought that the reason it has not healed is that the ring muscle (sphincter) that goes around the anus (back passage) has become so tense that the flow of blood to the lining of the anus is reduced.
Many anal fissures heal on their own. However, it's important to visit your doctor when you see blood in your stool or experience pain around your anus. Your doctor can do a rectal exam.
Anal fissures can make having a bowel movement (pooping) very painful. The pain may make it hard for you to have a bowel movement, causing constipation (having fewer bowel movements than usual). They can also cause bleeding from your anus.
Anal fissures persisting for longer than four weeks, or recurrent fissures, are generally defined as chronic. Chronic anal fissures have distinct anatomical features, such as visible sphincter fibers at the fissure base, anal papillae, sentinel piles, and indurated margins.
Anal fissures are categorized as small tears in the anal surface lining and may cause a feeling of pressure or pain near the rectum area. These are typically caused by trauma from constipation or passing stool, but may be from a more concerning underlying issue.
Your doctor will likely ask about your medical history and perform a physical exam, including a gentle inspection of the anal region. Often the tear is visible. Usually this exam is all that's needed to diagnose an anal fissure. An acute anal fissure looks like a fresh tear, somewhat like a paper cut.
At times chronic anal fissures can be pain free and not bleed the only symptoms is the inability to pass stool (straining to stool against a closed sphincter). Fissures are quite common in the general population, but are often confused with other causes of pain and bleeding, such as hemorrhoids.
During an anoscopy:
Your provider will gently insert a gloved, lubricated finger into your anus to check for hemorrhoids, fissures, or other problems. This is known as digital rectal exam. Your provider will then insert a lubricated tube called an anoscope about two inches into your anus.
These may include a medicated cream (to help heal the fissure), a topical muscle relaxant (to relax the anal muscles), an anesthetic ointment (to reduce pain, if pain interferes with having a bowel movement), or nitroglycerin or calcium channel blocker ointments (to relax the anal muscles and increase blood flow to the ...
Petroleum jelly, zinc oxide, 1% hydrocortisone cream, and products like Preparation H can help soothe the area. Instead of toilet paper, use alcohol-free baby wipes that are gentler on the area. Sitz baths can help heal fissures and make you feel better.
Diarrhea can worsen the fissure. Pain medications – Over-the-counter anti-inflammatory agents (example: Ibuprofen, Advil, Aleve, and Motrin) are the preferred medications to decrease inflammation and help with pain.
Once a fissure develops, the internal anal sphincter typically goes into spasm, causing further separation of the tear, constricting blood flow to the area, impairing healing, and causing pain.