Anal Fissure - Topic Overview
How is it treated?
Most short-term anal fissures can heal with home treatment in 4 to 6
weeks. Pain during bowel movements usually goes away within a couple of days after the start of
There are several steps you can take to relieve your symptoms and help the fissure heal:
- Try to prevent constipation. For example:
- Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
- Drink plenty of fluids.
- Get some exercise every day.
- Take a fiber supplement, such as Citrucel or Metamucil, every day if needed. Start with a small dose. Then very slowly increase the dose.
- Schedule time each day for a bowel movement. Take your time. Don't strain.
- Try taking stool softeners or
laxatives to make bowel movements less painful. Ask your doctor how long
you should take laxatives.
- Sit in a tub filled with a few
inches of warm water for 20 minutes, 2 or 3 times a day. This is called a sitz bath. It soothes the torn tissue and helps relax the
internal anal sphincter.
- Talk with your doctor about whether to try a nonprescription cream such as zinc oxide,
Preparation H, Anusol, or 1% hydrocortisone for a short time. These may help soothe anal tissues. But
fiber and sitz baths help symptoms more.1
- Instead of
using toilet paper, use baby wipes or medicated pads, such as Tucks, to clean
after a bowel movement.
Don't avoid having bowel movements. Knowing that it might hurt may make you anxious. But trying not to have bowel movements will only make constipation worse and keep the fissure open and painful.
What happens if the fissure doesn't heal on its own?
About 9 out of 10 short-term fissures heal with home treatment—including using stool
softeners or fiber supplements and taking regular sitz baths. And about 4 out of 10 long-term
anal fissures will heal after home treatment is used.1
But not all fissures will heal with just home treatment. If a fissure lasts more than 8 to 12 weeks, you may need prescription medicines.
These may include nitroglycerin cream, high
blood pressure medicines in pill or gel form, or injections of botulinum toxin (Botox).
If medicines don't stop your symptoms, you may
need to consider surgery. The most
commonly used surgery is lateral internal sphincterotomy. In this procedure, a
doctor cuts into part of the internal sphincter to relax the spasm that is
causing the fissure.