Dr. SHRIVASTAV B. S. A. M. MUM, Dr.GUPTA B. Sc., B. A. M. S.



Fissure, created by stool tearing the anus, which is generally an acute, sharp pain. There may be associated muscle spasm, resulting in prolonged pain over hours e.g. [The passage of difficult stool or severe diarrhea might tear the lining tissue with the anus. This dilemma is similar to having creaked lips in cold weather never ending and blood vessels are exposed in order that pain and bleeding over with bowel movement.]


Some of the causes include:

1. chronic constipation

2. passing a dry, hard stool

3. rough or excessive wiping of the anus after passing a motion

4. diarrhoea

5. inflammation of the anus and rectum

6. Crohn’s disease

7. scratching (as a reaction to pinworm infection, for example)

8. anal injury

9. pregnancy

10. childbirth

11. cancer of the rectum.

Chronic constipation and chronic diarrhea can also cause an anal fissure by repeatedly straining the lining of the anus.


1. a visible tear in the skin around the anus

2. a skin tag, or small lump of skin, next to the tear

3. Sharp pain in the anal area during bowel movements.

4. Anal fissures commonly bleed in infants.

5. streaks of blood on stools or on tissue paper after wiping

6. burning or itching in the anal area

7. Constipation can result in the passage of a larger, harder stool that causes further trauma and makes the fissure worse.

8. The pain also can affect urination by causing discomfort when urinating (dysuria), frequent urination, or the inability to urinate.

9. Bleeding in small amounts, itching (pruritus ani), and a malodorous discharge may occur due to the discharge of pus from the fissure.


1. The most important prerequisite to healing is to minimize pressure on the anus while passing stools and manage the pain during and after bowel movements.

2. You can do by making dietary changes that enable easier passage of stools,

3. Avoid chilies, and hard to digest foods.

4. Stay hydrated by including lots of fluids and roughage to your diet.

5. Apply coconut oil, aloe compresses and wheat germ oil to the affected areas to speed up curing. These natural home products have antiseptic and healing qualities.

6. Sitting in warm water for about twenty minutes, three times a day, can provide considerable relief. This is known as known as sitz bath. The warmth of the water will minimize chances of infection and improve blood circulation. This will help in muscle recovery and healing.

7. It is best to keep the area dry to avoid infection and other discomforts like itching and burning. You can dab a little baby powder after a shower, but avoid cosmetics that are scented or harsh on the skin.

8. Cleaning the anus with soft facial tissues is better than using normal toilet paper. This will minimize irritation to the sore tissues.

9. Cleaning the area a couple of times in a day with an infusion of chamomile and witch hazel will help the blood vessels to shrink and heal quickly.

10. Treatment for fissure will be required especially if they do not heal in six weeks time. Fissures can be cured through certain preventive measures and medications:

11. Your physician can prescribe a local anaesthetic like Lidocaine cream, ointment or suppositories to stop the pain in the anus.

12. You may have to use a surgical procedure to remove the fissure if the medications fail to improve your condition. It is called lateral internal sphincterotomy (LIS), and entails a small cut in the internal sphincter muscle to relieve the pressure within your anus and stop it from going into spas.

Preventing an anal fissure

1. The following are tips for preventing an anal fissure:

2. Keep your stools soft - eat a well balanced diet with plenty of fiber. Make sure your fluid/liquid intake is adequate - remember that water is the best fluid.

3. Don't delay going to the toilet - when you feel like going..poo Don't put it off. If you do, the stools that eventually come through will be larger and harder.

4. Babies - frequent diaper changes can reduce the risk of anal fissures developing in babies.

5. Wiping - if you are susceptible, use moistened cloths or cotton pads to clean yourself after going to the toilet. Don't use rough and/or perfumed toilet paper.

6. Exercise - regular exercise can reduce the risk of developing constipation, resulting in less risk of anal fissures. Make sure you are well hydrated during and after exercise (plenty of fluids).

7. Straining - avoid straining and sitting in the toilet for a long time. If you like reading in the toilet and are susceptible to anal fissures, you may have to seriously consider not bringing any reading material with you to the toilet.

If diarrhoea then treat immediately

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