Anal Fissure

Anal fissure is a condition, which involves a crack in the anal canal. It results from increased pressure within the anal canal, which can be due to constipation, passing large hard stools or frequent loose stools. It develops with equal frequency in both males and females. Usually younger and middle aged persons are affected.

Damaged anal mucosa in anal fissure

Causes of Anal Fissure

Damage to anal canal mucosa can be due to a lot of factors. A few important causes are listed below:


Straining while passing hardened large stool might lead to fissure formation.

  • Chronic Diarrhea

    Passing of loose stools frequently on long term might cause mucosal irritation in anal canal. This, in future can lead to fissure formation.

  • Anal Sex

    Anal sex can damage the anal canal by causing a tear or irritaion which further leads to fissure formation.

  • Infections

    Long term infections like Syphilis, Crohn’s disease, TB, HIV and anal cancer can cause secondary anal fissure.

Symptoms of Anal Fissure

The commonest symtoms experienced by these patients are:

  • Severe pain while passing stools
  • Bright red blood in stools
  • Itching or irritation around the anus
  • A small swelling (called as skin tag) may be seen near the skin around the fissure

Diagnosing Anal Fissures

95% of the time, carefully listening to patient’s medical history and proper anal examination will help us come to a diagnosis.

Anal examination

If a fissure is seen in the midline of the anus, we can identify it as primary fissure. Whereas, if the fissure presents in any other area away from the mid part, further testing is required to identify the cause of anal fissure.


This is a method to view inside the anus and rectum which helps to identify any underlying disease condition. More..

Treatments for Anal Fissure

Medical Treatments

  • Medicines that soften and loosen stools help relieve constipation and aids in easy passage of stools.
  • Specific medications help in faster healing of anal fissures. The fissures heal by 50% with 4 weeks of treatment.

Surgical Treatments

Lateral internal anal sphincterotomy is the procedure of choice for fissure in which itching, pain and bleeding persists even after a prolonged medical treatment and proper diet.

Prevention of anal fissures

Though there are no clear-cut methods to prevent anal fissure, lifestyle changes and avoiding risk factors might be helpful.

  • Diet rich in fiber is advised. Fiber rich diet includes fruits, vegetables, wheat, oats and barley.
  • Getting treated for diarrhea and constipation as early as possible is helpful for preventing fissures formation.

Anal fissure Specialists

Dr. J. S. Rajkumar


M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)

Dr. S. Akbar