Anal Fissures
Treatment is tailored depending on whether the fissure is acute (recent) or chronic (long-standing).
High-fiber diet (fruits, vegetables, whole grains)
Adequate hydration
Stool softeners
Warm sitz baths (10–15 minutes, 2–3 times daily)
Topical medications to relax the anal sphincter
Topical ointments to break the pain and spasm cycle
These treatments aim to:
What is an Anal Fissure?
An anal fissure is a small tear in the lining of the anal canal, most commonly caused by passing hard stools or straining during bowel movements. It is a common and treatable condition, but can cause significant discomfort if not addressed early.
Symptoms of Anal Fissure
Patients with an anal fissure may experience:
For chronic fissures and fissures not responding to conservative management:
When Should You See a Specialist?
You should consult a colorectal surgeon if:
Early evaluation ensures accurate diagnosis and effective treatment, while also ruling out other conditions.
Yes, most acute fissures heal with conservative treatment such as diet changes, hydration, and medications. Surgery is reserved for chronic or persistent fissures.
Yes, there is significant symptom overlap and it is important to have a reasonably accurate diagnosis to ensure targeted treatment is offered. A specialist colorectal surgeon should be able to make a diagnosis and initiate treatment. Occasionally sigmoidoscopy may be performed to rule out other lower GI causes of anorectal bleeding and pain.
Acute fissures may heal within a few weeks, while chronic fissures may take longer and sometimes require surgical treatment.
This depends on the procedure. Botox injection is pain free, however lateral sphincterotomy is more painful. However, the procedure is generally well tolerated. Most patients experience significant relief from fissure pain after surgery.
Recurrence is possible but can be minimised by maintaining a high-fiber diet, staying hydrated, and avoiding constipation and straining.
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