Understanding and Treating Anal Fissures

Anal fissures are a common but often painful condition that can make everyday activities, especially bowel movements, uncomfortable. While fissures may heal on their own in some cases, persistent symptoms can interfere with quality of life and may require medical treatment. At NYGA, our gastroenterologists help patients identify the cause of anal fissures and develop effective treatment plans to promote healing and prevent recurrence.

What Is an Anal Fissure?

An anal fissure is a small tear in the lining of the anus. This delicate tissue can be injured when stretched or irritated, leading to pain and bleeding. Anal fissures are most often associated with irregular bowel habits and can affect people of all ages.

How anal fissures form

Fissures typically form when hard or large stools stretch the anal canal, leading to tissue tears. Once a fissure develops, pain during bowel movements can trigger muscle spasms in the anal sphincter. These spasms reduce blood flow to the area, slowing healing and creating a cycle of ongoing discomfort.

What Causes Anal Fissures?

Several factors can increase the risk of developing an anal fissure, including chronic constipation, straining during bowel movements, and passing hard stools. Frequent diarrhea, childbirth, anal trauma, and inflammatory bowel disease can also contribute. In some cases, fissures may occur without a clear cause, especially when bowel habits fluctuate.

Common Symptoms of Anal Fissures

Sharp pain during or after bowel movements

The most common symptom is sharp or burning pain during a bowel movement that may persist for minutes to hours afterward. Many patients describe the pain as intense and localized.

Itching, burning, or spasms

Fissures can also cause itching, irritation, or a burning sensation around the anus. Muscle spasms in the anal sphincter are common and can worsen pain while delaying healing.

How symptoms differ from hemorrhoids

While both fissures and hemorrhoids can cause pain and bleeding, fissure pain is typically sharper and occurs specifically during bowel movements. Hemorrhoids more often cause pressure, discomfort, or itching rather than intense pain. A gastroenterologist can determine the cause through a physical exam and medical history.

Preventing Anal Fissures from Returning

Prescription ointments (nifedipine, nitroglycerin)

Topical prescription medications, such as nifedipine or nitroglycerin ointment, help relax the anal sphincter muscle and improve blood flow to the fissure, thereby encouraging healing. These treatments are often effective for chronic fissures when used consistently.

Botox injections

In some cases, anal Botox injections may be recommended to relax the sphincter muscle temporarily. This reduces spasms, allows for better blood flow to the fissure, and allows the fissure to heal without surgery.

Medical Treatments for Anal Fissures

Treatment depends on the severity and duration of symptoms. Conservative care often includes increasing fiber intake, using laxatives, staying well-hydrated, and using stool softeners to minimize straining. Sitz baths can also help soothe discomfort and improve circulation.

If fissures do not heal with these measures, prescription medications, Botox therapy, or advanced interventions may be necessary. Early treatment can prevent chronic pain and complications.

Get Expert Anal Fissure Treatment in NYC

Anal fissures can be painful but are highly treatable with proper care. At NYGA, our experienced gastroenterologists provide comprehensive evaluation and personalized treatment plans to help patients heal and avoid recurrence.

 

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