Digestive Disorders Health Center

Most short-term (acute) and a few long-term (chronic) anal fissures will heal with home treatment.

• Avoid constipation:
  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
  • Get some exercise every day. Try to do moderate activity at least 2� hours a week. Or try to do vigorous activity at least 1� hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.
  • Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Start with a small dose and very slowly increase the dose over a month or more.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
• Stool softeners or laxatives can make bowel movements more comfortable. Ask your doctor how long you should take laxatives.
• Sitting in a tub filled with a few inches of warm water (sitz bath) for 20 minutes 2 or 3 times a day soothes the torn tissue and helps relax the internal anal sphincter. This may help heal the anal fissure.
• You may want to use ointments or creams such as zinc oxide, Preparation H, or Anusol (which includes an anesthetic). But evidence suggests that fiber and sitz baths help symptoms better than nonprescription creams.¹ Creams with hydrocortisone (such as Anusol-HC) can reduce itching and inflammation.
• Although some people may be tempted to use a mirror or have a family member examine a fissure, do not separate the buttocks. Doing so might slow healing of the fissure.
• Instead of using toilet paper, use baby wipes or medicated pads, such as Tucks, to clean after a bowel movement. These products can be less irritating to an anal fissure.

Conservative treatment measures-including using stool softeners or bulking agents and taking regular sitz baths-allow about 9 out of 10 acute anal fissures to heal. And about 4 out of 10 long-term (or chronic) anal fissures will heal after conservative treatment is used.¹