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Anal Fissures

An anal fissure is a small tear or ulcer in the tissue that lines the anus.

What is an anal fissure?

If you pass particularly large or hard stools, this can cause an anal fissure, a small cut or sore in the anus lining.

What are the symptoms of an anal fissure?

Symptoms of an anal fissure include:

  • Sharp pain when you pass a stool
  • Bleeding when you pass a stool
  • Pain following a bowel movement for up to several hours
  • A crack you can see in the skin surrounding the anus
  • Lump on the skin around the anus

What causes an anal fissure?

An anal fissure develops due to an injury to your anal canal, commonly due to:

  • Constipation
  • Diarrhoea
  • Conditions affecting the bowel – such as Crohn’s or ulcerative colitis
  • Pregnancy / childbirth
  • Anal trauma
  • Less commonly, other serious conditions – such as anal cancer, HIV or tuberculosis

How is an anal fissure diagnosed?

If you do feel discomfort from what you think is an anal fissure, see your doctor. To make a diagnosis, your doctor will ask you about your symptoms and give you a gentle physical exam.

You might be referred for other tests, including an anoscopy, flexible sigmoidscopy or colonoscopy if your doctor thinks you an underlying condition may have caused your fissure.

How is an anal fissure treated?

Anal fissures usually heal a few weeks after you get them if you manage to make your stool softer. Your doctor may recommend:

  • Eating more high-fibre foods
  • Drinking more water
  • Warm baths

If your fissure does not go away, you may then be recommended:

Topical creams. These include:

  • Topical analgesics
  • GTN ointment
  • Diltiazem cream

Surgical options:

  • Botox injection in the anal sphincter muscle usually under a short general anaesthetic
  • Lateral Sphicterotomy under general anaesthetic

Our experts will help you decide which surgical option is best for you.

This content has been checked and approved by

Professor Richard Cohen  ›

Professor Richard Cohen is a Colorectal Consultant at King Edward VII’s Hospital.

Find your specialist in anal fissures at King Edward VII's Hospital

If you suspect you have an anal fissure and you’re seeking an expert opinion, you can find the UK’s leading colorectal specialists here at King Edward VII’s Hospital. Our consultants are hand-picked for you, making it easy to access the best possible care.

Mr Eric Alexandre Chung  ›
Special interests include:
Colorectal cancer (+ 12) more
Mr Roger Springall  ›
Special interests include:
General surgery (+ 13) more
Mr Alexander Von Roon  ›
Special interests include:
Colorectal cancer (+ 30) more
Professor Richard Cohen  ›
Special interests include:
Colorectal surgery (+ 11) more

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