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Anal Fissure - Topic Overview

How is an anal fissure diagnosed?

A doctor can diagnose an anal fissure based on your symptoms and a physical exam. The exam may include:

  • Looking at the fissure by gently separating the buttocks.
  • A digital rectal exam camera.gif. The doctor inserts a gloved finger into the anal canal.
  • Anoscopy. This involves using a short, lighted scope to look into the anal canal.

The doctor may wait until the fissure has started to heal before doing a rectal exam or anoscopy. If an exam needs to be done right away, medicine can be used to numb the area.

During an exam, a doctor can also find out whether another condition may be causing the fissure. Having several fissures or having one or more in an area of the anus where fissures usually don't occur can be a sign of a more serious problem, such as inflammatory bowel disease or a weakened immune system.

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 home treatment.

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. Read and follow all instructions on the label.
    • 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 pads or Preparation H wipes, 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.

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