Learn About Anal Fissure

What is the definition of Anal Fissure?

An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).

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What are the alternative names for Anal Fissure?

Fissure in ano; Anorectal fissure; Anal ulcer

What are the causes of Anal Fissure?

Anal fissures are very common in infants, but they may occur at any age.

In adults, fissures may be caused by passing large, hard stools, or having diarrhea for a long time. Other factors may include:

  • Decreased blood flow to the area
  • Too much tension in the sphincter muscles that control the anus

The condition affects males and females equally. Anal fissures are also common in women after childbirth and in people with Crohn disease.

What are the symptoms of Anal Fissure?

An anal fissure can be seen as a crack in the anal skin when the area is stretched slightly. The fissure is almost always in the middle. Anal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet paper (or baby wipes) after a bowel movement.

Symptoms may begin suddenly or develop slowly over time.

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What are the current treatments for Anal Fissure?

Most fissures heal on their own and do not need treatment.

To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently.


Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make the anal fissure worse.

Prevent hard stools and constipation by:

  • Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains
  • Drinking more fluids
  • Using stool softeners

Ask your provider about the following ointments or creams to help soothe the affected skin:

  • Numbing cream, if pain interferes with normal bowel movements
  • Petroleum jelly
  • Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products

A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks.

If the anal fissures do not go away with home care methods, treatment may involve:

  • Botox injections into the muscle in the anus (anal sphincter)
  • Minor surgery to relax the anal muscle
  • Prescription creams, such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles
Who are the top Anal Fissure Local Doctors?
Highly rated in

University Of Palermo

General Surgery Unit, Department Of Surgical, Oncological And Stomatological Sciences 
Palermo, IT 

Beatrice D'orazio is in Palermo, Italy. D'orazio is rated as an Elite expert by MediFind in the treatment of Anal Fissure. She is also highly rated in 2 other conditions, according to our data. Her top areas of expertise are Anal Fissure, Pinworms, Hernia, and Femoral Hernia.

Highly rated in

University Of Mansoura

Al Mansurah, DK, EG 

Sameh Emile is in Al Mansurah, Egypt. Emile is rated as an Elite expert by MediFind in the treatment of Anal Fissure. He is also highly rated in 20 other conditions, according to our data. His top areas of expertise are Gastrointestinal Fistula, Rectal Prolapse, Anal Fissure, and Rectocele.

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Highly rated in


Rome, IT 

Giuseppe Brisinda is in Rome, Italy. Brisinda is rated as an Elite expert by MediFind in the treatment of Anal Fissure. He is also highly rated in 4 other conditions, according to our data. His top areas of expertise are Anal Fissure, Retroperitoneal Liposarcoma, Ileostomy, and Leiomyosarcoma.

What is the outlook (prognosis) for Anal Fissure?

Anal fissures often heal quickly without any more problems.

People who develop fissures once are more likely to have them in the future.

Anal fissure - series
What are the latest Anal Fissure Clinical Trials?
Sungurtekin Technique vs. Closed Lateral Internal Sphincterotomy for Chronic Fissure-in-Ano: A Prospective, Randomized, Controlled Trial of a New Technique
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Assessment of Efficacy and Side Effects of Dlitiazem Ointment With Lidocaine vs. Diltiazem Ointment With Lidocaine for Treatment of Chronic Anal Fissure: Randomized Clinical Trial
What are the Latest Advances for Anal Fissure?
New Techniques in Hemorrhoidal Disease but the Same Old Problem: Anal Stenosis.
Lateral Internal sphincterotomy is still crucial to heal hypertonic chronic anal fissure and normalize the internal anal sphincter tone? Is V-en Y plastic a valuable alternative?
Tired of the same old research?
Check Latest Advances
Botulinum Toxin Injection Plus Topical Diltiazem for Chronic Anal Fissure: A Randomized Double-Blind Clinical Trial and Long-term Outcome.
Who are the sources who wrote this article ?

Published Date : May 17, 2020
Published By : Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Downs JM, Kulow B. Anal diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 129.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 371.

Merchea A, Larson DW. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 52.