General Surgery

Understanding Anal Fissures: Causes and Treatment Options:

Anal fissures are a common condition characterized by small tears or cracks in the lining of the anus. They can cause pain, discomfort, and bleeding during bowel movements, affecting individuals of all ages. 

Causes of Anal Fissures:

  • Constipation: Hard and dry stools can put excessive strain on the anal canal, leading to the development of fissures.
  • Diarrhea: Frequent loose stools can irritate the delicate anal tissues, making them more prone to fissures.
  • Trauma or Injury: Injury to the anal area, such as during childbirth or excessive anal stretching, can cause fissures.
  • Chronic Conditions: Conditions like inflammatory bowel disease (IBD), Crohn’s disease, or sexually transmitted infections can increase the risk of developing anal fissures.

Symptoms of Anal Fissures:

  • Intense pain during bowel movements.
  • Bright red blood on toilet paper or in the stool.
  • Itching, burning sensation, or discomfort around the anus.
  • Muscle spasms in the anal region (anal sphincter).

Treatment Options:

Lifestyle Modifications:

  • High-Fiber Diet: Consuming fiber-rich foods such as fruits, vegetables, and whole grains can soften stools and prevent constipation, reducing the risk of fissure formation.
  • Hydration: Drinking an adequate amount of water helps maintain soft stools and prevents dehydration, which can worsen constipation.
  • Sitz Baths: Sitting in warm water for 10-15 minutes several times a day can promote relaxation of the anal muscles and relieve discomfort.


  • Stool Softeners: These medications help soften the stools and ease bowel movements, reducing strain on the anal area.
  • Calcium Channel Blockers: These drugs help relax the anal sphincter muscles, reducing pain and promoting healing.

Surgical Intervention:

Lateral Internal Sphincterotomy: In cases where conservative measures fail, a surgical procedure called lateral internal sphincterotomy may be performed. It involves cutting a small portion of the anal sphincter muscle to reduce muscle spasm and promote healing.

Anal fissures can cause significant discomfort and disrupt daily life activities. However, with proper treatment and lifestyle modifications, most fissures heal within a few weeks. It is essential to address the underlying causes, such as constipation or diarrhea, to prevent recurrent fissures. If symptoms persist or worsen despite conservative measures, it is recommended to consult a healthcare professional who can provide further guidance and recommend appropriate treatment options.