causes of anal fissure

An anal fissure is a tear or crack, in the anus and anal canal. It can be acute or chronic. The initial symptoms include pain during and after bowel movements with bleeding, itching and malodorous discharge. Usually, anal fissure is less than one centimeter across, but the pain due to fissures may be quite severe as the anus is a very sensitive part of the body. Even a small tear can cause pain and discomfort.

Anal fissure can occur due to a number of causes:

  • Constipation and straining – Constipation and straining during bowel movements and passing hard stools can be the cause of anal fissures.
  • Persistent Diarrhea -Repetitive diarrhea also can be a cause of an anal fissure.
  • Pregnancy and childbirth – Pregnant women have a higher risk of getting an anal fissure in their later pregnancy and during childbirth.
  • Sexually transmitted diseases/infections-Syphilis, HIV, HPV, and herpes are the kind of diseases that have an association with a higher risk of having anal fissures.
  • Anal sex – Very rare but it can cause anal fissures.
  • Underlying conditions -Some underlying conditions, like Crohn’s disease and other inflammatory bowel diseases, may cause anal fissures.
  • Muscle spasms- There are two muscular rings also known as sphincters control the anus. The outer ring is consciously in control but the inner ring is not and is under constant pressure. It is said that, when the pressure increases to a large extent, the inner sphincter might spasm, decreasing the blood flow and increasing the risk of fissures.

When do you need to see a doctor?

Most people have an acute anal fissure and increasing the fiber diet can help you treat your problem within a few days. On the other side, symptoms are persistent where consulting a doctor is beneficial. 

Treatment options

Home remedies to treat anal fissure

  • increase fiber intake to your diet
  • drink enough fluid
  • avoid straining during bowel movements

Non-surgical treatments

  • Warm water bath for 10-15 minutes
  • Over-the-counter ointments for fissure
  • Botox injection to paralyze the anal muscle and relax spasm

Surgical treatment

If no treatment works, the doctor suggests surgery – sphincterotomy. The procedure involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain and helps in healing. 


The best way to minimize the risk of anal fissure is to make lifestyle changes. If that doesn’t help then do not delay your treatment and consult the best proctologist for anal fissure. 

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