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- What causes an anal fissure?
- Most anal fissures are caused by injury to the area. This can happen when you pass a hard or large stool (poo). Other causes include:
- constipation
- diarrhoea
- anal injuries
- pregnancy or childbirth
- Crohn’s disease
- There are other, less common, causes of anal fissures such as:
- cancer
- HIV
- tuberculosis
- syphilis
- sexually transmitted infections (STIs), such as genital herpes
- When should I see my doctor?
- You should see your doctor if:
- there is blood on your stool
- there is blood on your toilet paper
- you have pain when you are doing a poo
- How is an anal fissure diagnosed?
- Your doctor will talk to you and examine you.
- Your doctor might need to examine the area and possibly look inside your anus and rectum. This may be done by inserting a gloved finger into the anus.
- Your doctor may also use a small instrument called an anoscope to examine the area.
- If the cause of the bleeding or pain is not clear, your doctor may refer you to a specialist. They may recommend a colonoscopy. This is a procedure to look inside the bowel, done at a hospital or a day surgery centre.
- How is an anal fissure treated?
- There are 3 different treatment approaches to treatment:
- conservative treatment
- botox
- surgery
- Conservative treatment
- Conservative treatment usually works, in 6-8 weeks. It involves eating lots of high-fibre foods and drinking lots of water to soften your stools (poos). This will ease the pain and muscle spasm around your anus.
- You can also take warm baths and apply a muscle relaxant cream (such as 0.2% glyceryl trinitrate) to the area twice a day. This cream is only available from pharmacists and there are some significant side effects. You should speak with your pharmacist or doctor before using it
- If needed, you can take pain relief medication such as paracetamol.
- Botox
- Botox is a chemical that is injected into the muscles around the anus to help them relax. Botox usually lasts for 2 to 3 months. This allows the fissure to heal.
- Surgery
- Your doctor may recommend surgery if other treatments have not been helpful.
- Anal fissure surgery is known as a sphincterotomy. A small cut is made into your sphincter muscle, which relieves tension. You can have this as day surgery.
- Can anal fissures be prevented?
- You can prevent anal fissures by eating high-fibre foods, exercising regularly and drinking lots of water. These all help digestion and bowel health, and help prevent constipation.
- It’s also important to wipe your bottom gently after going to the toilet.
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