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Anal fissures, or rectal fissures, are small tears in the tissue of the anus. Often, they can heal on their own with time. However, when they’re persistent and painful, WakeMed’s colorectal surgery experts provide options for effective relief.
Signs that you may have an anal fissure include:
A common cause is passing hard and large stool during a bowel movement. Both chronic constipation and diarrhea can also cause a fissure, as well as anal intercourse and childbirth.
Other risk factors include having:
Our doctors will start by taking a full medical history and performing a physical examination of the anal area. Typically, a doctor can diagnose anal fissures through a simple visual examination.
If the doctor believes further tests may help to determine an underlying condition, patients may undergo tests including:
Generally non-surgical treatments will be recommended first, and many fissures can heal on their own with the proper self-care. Patients will be encouraged to drink fluids, eat high-fiber foods, and exercise regularly.
Patients should avoid straining during bowel movements, and long periods of sitting – both of which can increase pressure in the anal and rectal area. Warm tub baths can also speed up the healing process.
If the fissure doesn’t heal on its own, medications may also be prescribed. These may include topical anesthetic cream, nitroglycerin, and nifedipine ointment. If those treatments don’t work, surgical treatment of anal fissures is considered.
For severe or chronic anal fissures that are not healing with medication, surgery is an effective option.
Our colorectal surgeons can perform a lateral internal sphincterotomy, which involves cutting a small portion of the anal sphincter muscle. This reduces spasms of the sphincter muscle and lessens the pain, and can help the area heal more effectively.
Another way to fix anal fissures is perianal Botox injection. The effect lasts 3 to 6 months.
If you or someone you care for is experiencing worrisome symptoms, we encourage you to make an appointment with one of our adult gastroenterologists, pediatric gastroenterologist or colorectal surgeons.
3000 New Bern Ave.
Raleigh, NC 27610