Anal Fissures

An anal fissure is a tear in the thin, sensitive tissue that lines the anal canal. This area plays an essential role in bowel control, and even a minor injury can cause sharp pain and bleeding. Anal fissures may occur at any age and can develop suddenly or over time.

How anal fissures develop

Most fissures develop when the anal lining is overstretched or irritated. Passing hard or large stools can strain the tissue and cause a tear. Once a fissure forms, pain during bowel movements can trigger involuntary muscle spasms in the anal sphincter. These spasms reduce blood flow to the area, slowing the healing process and increasing the likelihood that the fissure will become chronic.

Several factors can increase the risk of developing an anal fissure. Chronic constipation and straining during bowel movements are the most common causes. Frequent diarrhea, prolonged sitting on the toilet, childbirth, and anal trauma may also contribute.

Chronic conditions that contribute to fissures

Certain medical conditions can increase the likelihood of fissures or make them harder to heal. Inflammatory bowel disease (IBD), including Crohn’s disease, can increase inflammation in the anal canal. Other contributing factors include pelvic floor dysfunction and conditions that affect bowel habits or stool consistency.  

• Acute anal fissures are newly formed and often heal within a few weeks with conservative treatment such as dietary changes and stool softening.
• Chronic anal fissures persist longer than six weeks and may be associated with ongoing pain, repeated tearing, or visible scarring. Chronic fissures often require medical treatment to relax the sphincter muscle and promote healing.

The most common symptom of an anal fissure is sharp pain during or after bowel movements. This pain may last for minutes or even hours. Bright red blood in your stool or in the toilet bowl is also common. Some patients experience itching, burning, or muscle spasms in the anal area. Symptoms can often overlap with hemorrhoids; an evaluation by a gastroenterologist is important for an accurate diagnosis.

Prevention focuses on maintaining soft, regular bowel movements and reducing strain on the anal canal. Eating a fiber-rich diet, drinking plenty of fluids, and avoiding prolonged straining can significantly lower the risk. Managing underlying digestive conditions and addressing chronic constipation early can also help prevent fissures from returning.

At NYGA, anal fissure treatment is tailored to each patient’s symptoms and severity. Treatment options may include nutrition guidance, stool softeners, prescription topical medications to relax the sphincter muscle and help with pain, or advanced therapies for chronic fissures. 

Schedule an appointment with NYGA today to receive a comprehensive evaluation and effective treatment from one of NYC’s leading gastroenterology practices.