Anal Fissure

Medically reviewed by Drugs.com. Last updated on Jun 2, 2025.

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AMBULATORY CARE:

An anal fissure

is a cut or tear in the tissue inside your anus. An anal fissure may be acute or chronic. An acute anal fissure is usually small and shallow and often heals without treatment. A chronic fissure may last longer than a month and will usually need treatment. A chronic anal fissure comes back after treatment.

Signs and symptoms of an anal fissure:

• Pain that lasts several hours around your anus after you have a bowel movement
• Bleeding from your anus
• Bright red blood in your bowel movement or spots of blood on your toilet paper
• Pain while you urinate or have sex
• Spasms in your anus
• Itching around your anus

Seek care immediately if:

• You have severe pain in or around your anus.
• You have bleeding from your anus that does not stop.

Call your doctor if:

• You have a fever.
• You still have pain after you take pain medicine.
• You are not able to have a bowel movement.
• You have spasms in your anus that do not stop.
• You have questions or concerns about your condition or care.

Treatment

may include having the cause of your anal fissure treated. You may need any of the following to treat your anal fissure:

• Medicine:
  • Stool softeners help make your bowel movements softer. This helps prevent constipation. You will be less likely to strain and cause an anal fissure if you are not constipated.
  • Topical medicines may be given to help your anal muscle relax or to increase blood flow to your anus. Your provider will teach you the right way to use topical medicine.
  • Botulinum toxin is given as a shot into the skin around your anus. It helps your anal muscle relax.
• Surgery may be needed if other treatments do not work. You may also need surgery if your anal fissure is very painful. The most common surgery is called a lateral internal sphincterotomy. A small part of your anal muscle is cut to help relax your anal muscle and decrease your pain. A fissurectomy may be used to remove all or some of your anal fissure.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• Rectiv
• nitroglycerin

Manage or prevent an anal fissure:

• Soak in a warm tub or take a sitz bath. A sitz bath may decrease your pain and relax your anal muscle. You may need to do this more than 1 time each day. Ask your healthcare provider for information on how to use a sitz bath.
• Eat foods that are high in fiber. This will help keep your bowel movements soft. High-fiber foods include fruits, vegetables, and whole grains.
• Drink more liquids. Liquids may help soften your bowel movements. This will help prevent you from straining. Ask your provider how much liquid you should drink each day and which liquids are best for you.
• Do not ignore the urge to have a bowel movement. Do not strain. Clean the area gently after every bowel movement.
• Avoid anal intercourse for as long as directed by your provider. Anal intercourse may make it harder for your anal fissure to heal.

Follow up with your doctor as directed:

Your doctor will need to make sure your anal fissure heals. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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