Trauma or injury can stretch the anal canal and create a tear in the lining of the anus. These tears, known as anal fissures, typically come from passing large or hard stools. They usually cause pain and bleeding during and after passing stools.
The goal for anal fissure treatment is to relieve pain and discomfort and heal the torn lining. Acute anal fissures -- lasting no more than 6 weeks -- are very common and usually heal on their own with self-care. Chronic anal fissures -- those that last longer than 6 weeks -- may require medication or surgery to promote healing.
Certain self-care measures can help lessen the strain on the anal canal that may be caused by constipation or diarrhea. The following methods have been found to help relieve symptoms and encourage healing in most cases of anal fissure.
Stay hydrated. Drink plenty of caffeine-free fluids throughout the day. (Too much alcohol and caffeine can lead to dehydration.)
Maintain a fiber-rich diet. Your goal should be to consume 20 to 35 grams of fiber per day to avoid constipation. You can gradually increase your fiber intake by eating more:
whole grains, including brown rice, oatmeal, popcorn, and whole-grain pastas, cereals, and breads
peas and beans
seeds and nuts
prunes and prune juice
Try fiber supplements if you can’t get enough fiber through food. They can help soften stools and increase regularity. To avoid gas and cramping, gradually increase the amount of any fiber supplement you take until you reach the recommended dose.
Over-the-counter laxatives may help if adding more fiber to your diet does not. Before taking any laxatives, ask your doctor what she would recommend.
Don't ignore your urge to go. Putting off bowel movements for later can lead to constipation, meaning stools that are hard to pass and can cause more pain and ripping.
Don't strain or sit on the toilet too long. This can increase pressure in the anal canal.
Gently clean and dry your anal area after each bowel movement.
Avoid irritants to the skin, such as certain soaps or bubble baths.
Get treatment for chronic constipation or prolonged diarrhea.
Sitz baths, or hip baths, can be taken to promote healing of an anal fissure. By soaking the rectal area in a tub of warm water -- 2 to 3 times a day for 10 to 15 minutes -- you can cleanse the anus, improve blood flow, and relax the anal sphincter.
These conservative measures are typically enough to heal most anal fissures within a few weeks to a few months. But when these actions are not enough, more aggressive treatments can be applied for persistent or reoccurring fissures.