Anal FissureSymptoms, Doctors, Treatments, Advances & More
Learn About Anal Fissure
An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).
Fissure in ano; Anorectal fissure; Anal ulcer
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.
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.
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.
CHILDREN AND ADULTS
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 for 10 to 15 minutes each time. The water should cover only the hips and buttocks.
If the anal fissures do not go away with home care methods, treatment may involve:
- Botulinum toxin 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
Advocate Illinois Masonic Digestive Health Center
Jan Kaminski is a Colorectal Surgeon practicing medicine in Chicago, Illinois. Dr. Kaminski is rated as a Distinguished provider by MediFind in the treatment of Anal Fissure. He is also highly rated in 6 other conditions, according to our data. His clinical expertise encompasses Anal Fissure, Cellulitis, Hemorrhoids, Colostomy, and Ileostomy. Dr. Kaminski is board certified in American Board Of Colon & Rectal Surgery.
Baylor Scott & White Clinic - Temple
Pankaj Garg is a Cardiologist practicing medicine in Temple, Texas. Dr. Garg is rated as an Elite provider by MediFind in the treatment of Anal Fissure. He is also highly rated in 35 other conditions, according to our data. His clinical expertise encompasses Gastrointestinal Fistula, Anal Fissure, Hemorrhoids, Hemorrhoidectomy, and Gallbladder Removal.
Pierpaolo Sileri practices practicing medicine in Milan, Italy. Mr. Sileri is rated as an Elite expert by MediFind in the treatment of Anal Fissure. He is also highly rated in 14 other conditions, according to our data. His clinical expertise encompasses Rectal Prolapse, Anal Fissure, Gastrointestinal Fistula, Hemorrhoidectomy, and Ileostomy.
Anal fissures often heal quickly without any more problems.
People who develop fissures once are more likely to have them in the future.
Summary: This prospective randomized controlled trial compares three lateral internal sphincterotomy (LIS) techniques in patients with chronic anal fissure refractory to medical treatment: (1) Spasm-Controlled LIS (serial small sphincterotomies using an anal calibrator until 30 mm anal caliber is achieved, under local anesthesia plus sedation), (2) LIS up to the Fissure Apex (spinal or general anesthesia),...
Summary: This study aims to compare two commonly used treatments for chronic anal fissure: botulinum toxin injection and lateral internal sphincterotomy. Chronic anal fissure is a painful condition that causes severe discomfort during bowel movements and can significantly affect a patient's quality of life. Botulinum toxin injection is a minimally invasive procedure that temporarily relaxes the anal sphinc...
Published Date: April 11, 2026
Published By: Ann M. Rogers, MD, FACS, Professor Emeritus, Department of Surgery, Penn State College of Medicine, Hershey, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bleier JIS, Hernandez PT, Lowenfeld L. Benign anorectal disorders. In: Tyler DS, Hayes-Dixon A, Hines OJ, et al, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 22nd ed. Philadelphia, PA: Elsevier; 2026:chap 97.
Kliegman RM, St. Geme JW, Blum NJ, et al. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 392.
Madoff RD, Melton GB. Diseases of the rectum and anus. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 131.