Anal/Rectal Fissures

What Causes Anal/Rectal Fissures?

An anal/rectal fissure is a small tear in the skin that lines the anus. Anal/rectal fissures, similarly to hemorrhoids, can occur while passing dry, hard or large stools during constipation or a prolonged straining of the bowel during diarrhea or childbirth. Anal intercourse can also cause anal fissures. Anal/rectal fissures are commonly misdiagnosed and improperly treated with topical steroids. 

Diagnosing Anal/Rectal Fissures

Anal/Rectal fissures are typically located in the posterior position on the tailbone side of the anus. There may be a visible crack or skin tag also called a sentinel pile. Anal/Rectal fissures are associated with pain during bowel movements, pain after bowel movements lasting several hours, and anal/rectal bleeding. The pain, often described as passing glass, can be sharp and severe. Women who have just given birth, infants, and those suffering from Chron's disease, and the elderly commonly experience anal fissures. 

Treating Anal/Rectal Fissures

Soaking in warm water, taking stool softeners, and lubrication can help with anal/rectal fissures. Fissures are common when suffering from internal hemorrhoids. This combination can be very painful. The faster you seek out treatment, the faster you will experience relief.

In the past, fissures were treated with surgery. However, this is not necessary and may lead to incontinence. Relaxation of the internal sphincter allows for the fissure to heal. We may recommend topical medication such as Diltiazem to relax the muscle. Botox is sometimes injected for more difficult cases. This helps to lower the pressure of the rectal muscle, making it easier for the fissure to heal. We have found most fissures respond to our non-operative treatment. Do not agree to a possible unnecessary operation until you have evaluated our non-surgical hemorrhoid treatment.