Anal fissure is a tear or crack that occurs in the skin near the anal canal or rectum. It is typically caused by the stretching of the rectal skin beyond its capacity. This can occur when you have a hard or large bowel movement.

This can result in severe pain during and following bowel movements, Bleeding is often associated with the bowel movement. There also can be some pain, itching, and other symptoms.

Some heal on its own while others become chronic, meaning that the symptoms can improve for a time, then reoccur. In some cases, the anal fissure won’t heal on its own and will require additional treatment.


–  Rectal Bleeding
–  Rectal Spasm
–  Pain
–  Burning sensation
–  Leakage
–  Difficulty with bowel movement
–  Fever
–  Chills

Causes – More and Less common

–  Passing Hard Stool
–  Passing Large Stool
–  Bearing down – when constipated – pushing hard
–  Chronic Diarrhea
–  Crohn’s Disease
–  Other Inflammatory bowel disease
–  Childbirth

Less common causes

–  HIV
–  Herpes
–  Anal Cancer
–  Others
–  Anal Intercourse
–  Foreign objects placed into rectum


–  It is possible for some diagnosis to occur with physical exam – rectal exam by your medical provider
–  Flexible sigmoidoscopy
–  Colonoscopy


A major goal of treatment is to allow for looser stools and healing.  This in turn can decrease the pressure and inflammation of the rectum.

–  Fiber
–  Sitz bath
–  Xylocaine 2%
–  Nitroglycerine ointment 0.2%
–  Surgery is rare