An anal fissure is a small tear in the thin, moist tissue that lines the anus. It often happens after passing a large or hard stool, and while it is a minor problem, it can cause sharp pain and a little bright red bleeding that understandably worries people.
The good news is that anal fissures are very common and most of them heal with simple steps at home. When pain lingers or a tear keeps coming back, our gastroenterologists in Akron and Massillon can help it heal and keep it from returning.
Symptoms
- Pain during a bowel movement, sometimes sharp, that can last for hours afterward
- Bright red blood on the stool or on the toilet paper
- A visible tear or crack in the skin around the anus
- A small skin tag or bump near the tear, especially with a longer-standing fissure
The bleeding from a fissure is usually small and bright red. Because bleeding can have other causes, it is worth having any new or ongoing rectal bleeding checked rather than assuming you know the source.
What causes it
Most fissures come from the strain and stretch of passing large or hard stools, which is why constipation is such a common trigger. Ongoing diarrhea, tight anal muscles, and the changes that come with childbirth can play a role too. The discomfort can make people tense up or avoid going, which leads to harder stools and more irritation, so the cycle keeps feeding itself.
How we diagnose it
In most cases we can identify a fissure from your history and a gentle exam of the area. We will also ask about your bowel habits and any bleeding so we can rule out other causes, such as hemorrhoids, and make sure nothing more serious is being missed. If anything about your symptoms is unusual, we may recommend a closer look.
How we treat it
The first goal is to keep stools soft and comfortable so the tear can heal. That usually means more fiber, plenty of water, stool softeners, and warm water soaks, sometimes called sitz baths, to relax the area and ease pain. Topical anesthetic creams can calm the discomfort while you heal.
When a fissure is more stubborn, we have several options. Nitroglycerin ointment or certain blood pressure medications can relax the anal muscle and improve blood flow so the tissue can recover. For chronic fissures that do not respond, Botox injections can relax the muscle, and in some cases a short surgical procedure removes the tear and prevents it from returning. We will talk through the choices and start with the gentlest approach that fits your situation.
When to see us
Reach out if the pain is severe, if bleeding does not settle, or if a fissure keeps coming back after it seems to heal. If hemorrhoids are part of the picture, we also offer treatments like hemorrhoid banding when they are the right fit.
To get relief and a clear plan, request an appointment with The Gastroenterology Group or call us at (330) 869-0954. We welcome new patients in Akron and Massillon, and you do not need a referral to schedule a screening colonoscopy.