Anal fissure

An anal fissure is a small tear in the lining of the anal canal that can cause sharp pain during or after bowel movements. This page gives general information about typical symptoms, possible causes, how a fissure is usually assessed, and which medical specialties can offer evaluation and onward care.

What an anal fissure is

A fissure is a small linear tear of the anoderm (anal canal lining). It is often superficial but can cause notable pain and bright red bleeding. Fissures may be classified as acute or chronic; chronic fissures can show changes at the tear edges and sometimes require more detailed assessment.

Common symptoms and urgent signs

Typical complaints include sharp pain during or immediately after defecation, bright red blood on the stool or toilet paper, and local soreness. Seek urgent medical attention if bleeding is heavy or cannot be stopped, if intense pain begins suddenly, or if you have fever with spreading redness or swelling around the anus—these are signs that require prompt evaluation.

Typical causes and risk factors

Frequent causes include constipation with hard stools, anal trauma (for example during delivery or medical procedures), repeated episodes of diarrhea, and muscle spasm of the anal sphincter. Chronic inflammatory conditions and local skin disorders can increase risk. Diet and bowel habits also play a role.

How fissures are diagnosed and who to see

Diagnosis is usually based on medical history and a visual exam of the anal area. If there is concern for infection, inflammatory bowel disease or other anorectal conditions, additional tests or endoscopic evaluation may be recommended. General surgeons, gastroenterologists and colorectal (proctology) specialists commonly assess anal fissures. Primary care physicians can provide initial evaluation and referral.

Prevention and general self-care advice

To reduce the risk of recurrence, focus on preventing constipation by keeping well hydrated, eating a fiber-rich diet and avoiding prolonged straining. Gentle hygiene of the anal area and regular bowel routines can help. Persistent or worsening symptoms should be evaluated by a clinician to decide if further investigation or specialist care is needed.

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