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Definition Return to top
An anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).
Causes Return to top
Anal fissures are extremely common in young infants but may occur at any age. Studies suggest 80% of infants will have had an anal fissure by the end of the first year. The rate of anal fissures decreases rapidly with age. Fissures are much less common among school-aged children than infants.
In adults, fissures may be caused by constipation, the passing of large, hard stools, or by prolonged diarrhea. In older adults, anal fissures may be caused by decreased blood flow to the area.
Anal fissures are also common in women after childbirth and persons with Crohn's disease.
Symptoms Return to top
Anal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet tissue (or baby wipes) following a bowel movement.
Other symptoms may include:
Exams and Tests Return to top
The health care provider will perform a rectal exam and look at a sample of the rectal (anal) tissue.
Treatment Return to top
Most fissures heal on their own and do not require treatment, aside from good diaper hygiene in babies.
However, some fissures may require treatment. The following home care methods usually heal most anal fissures.
If the anal fissues do not go away with home care methods, treatment may involve:
Outlook (Prognosis) Return to top
Anal fissures generally heal quickly without further problems. However, people who develop fissures are more likely to have them in the future.
Possible Complications Return to top
Occasionally, a fissure becomes chronic and will not heal. Chronic fissures may require minor surgery to relax the sphincter.
When to Contact a Medical Professional Return to top
Call your health care provider if symptoms associated with anal fissure are present, or if the fissure does not heal appropriately with treatment.
Prevention Return to top
To prevent anal fissures in infants, be sure to change diapers frequently.
To prevent fissures at any age:
References Return to top
Danakas G. Anal Fissure. In: Ferri FF, ed. Ferri’s Clinical Advisor 2008: Instant Diagnosis and Treatment. 1st ed. Philadelphia, Pa: Mosby; 2008.Update Date: 7/17/2008 Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.