Anal Fissures: Painful Bowel Movements and Bleeding

An anal fissure is a small tear in the thin lining of the anus. It is a very common cause of pain and rectal bleeding, and it often happens after passing a hard stool.

Symptoms

• Sharp or burning pain during bowel movements, sometimes lasting hours afterward
• Bright red blood on toilet paper
• A small lump or skin tag near the tear

Causes

• Hard stools and constipation
• Frequent diarrhea
• Childbirth
• Less often, Crohn's disease or infection, especially if the fissure is in an unusual spot

Treatment

Home care (first step)

• Fiber supplements and plenty of water to keep stools soft
• Stool softeners if needed
• Warm sitz baths for 10 to 15 minutes, especially after bowel movements
• Avoid straining and long sitting on the toilet

Prescription treatment

If a fissure doesn't heal, creams such as nitroglycerin or diltiazem relax the anal muscle, improve blood flow, and help healing.

Procedures

For chronic fissures, options include Botox injection to relax the muscle, or a minor surgery (lateral internal sphincterotomy).

When to see a doctor

See us for any rectal bleeding, pain that doesn't improve in a couple of weeks, or fissures that keep coming back. Bleeding should be evaluated even if you think it's "just a fissure." Fissures are different from hemorrhoids, which can be treated with non-surgical banding.

Make an appointment

Our gastroenterologists in Temple City care for patients from Arcadia, San Gabriel, Pasadena, Monrovia, Monterey Park, and across the San Gabriel Valley. We accept most PPO plans (see accepted insurances), and our doctors speak English, Vietnamese, and Mandarin. Schedule an appointment or call 626-898-4560.

This article is for general education and is not a substitute for medical advice. Talk with your doctor about your own health.