Anal fissures can be quite painful and troublesome. An anal fissure is a tear in the tissue lining the anal canal, which can cause bleeding, itching, and pain.
These fissures are common and most often develop due to constipation or diarrhea. If left untreated, they may become chronic. This may damage the tissues of the sphincter muscle and prevent healing.
Hence, it is important to relax the muscles of the anal sphincter and keep your stool regular. Keep reading to find out more about anal fissures, the treatment options, and some diet tips to help you manage the condition.
What Is An Anal Fissure?
An anal fissure is a slight tear that occurs in the moist tissue lining the anus. It is usually a result of passing hard or large stools during a bowel movement.
Anal fissures cause great discomfort and are often accompanied by pain and bleeding while passing stools. The ring of muscle at the end of your anus, also called the anal sphincter, may experience spasms due to such fissures.
The common causes of anal fissures are discussed below.
What Causes An Anal Fissure?
Anal fissures may be caused by:
- Passing hard or large stools during a bowel movement
- Constipation that causes one to strain during a bowel movement
- Anal intercourse
- Childbirth
- Chronic cases of diarrhea
The less common causes of anal fissures include:
- Inflammatory bowel diseases like Crohn’s disease
- Anal cancer
- Syphilis
- HIV
- Tuberculosis
Some factors may put an individual at a higher risk of developing anal fissures.
Risk Factors
The risk factors for anal fissures are:
- Childbirth – Anal fissures are quite common in women after giving birth.
- Constipation
- Age – While anal fissures may occur at any age, they are more common in middle-aged adults and infants.
Individuals affected by anal fissures tend to exhibit the following signs and symptoms.
Signs And Symptoms Of Anal Fissures
The signs and symptoms associated with anal fissures are:
- Pain during bowel movements, which may vary in severity
- Pain that lasts up to several hours after passing stool
- Blood spots in the stool (or toilet paper) after a bowel movement
- A noticeable crack in the skin around the anus
- Presence of a small skin tag on the skin near the anal fissure
If you experience any of these symptoms, it is best to get yourself diagnosed to rule out other possibilities.
How Are Anal Fissures Diagnosed?
To diagnose anal fissures, your doctor may ask about your medical history. This may be followed by a physical examination that includes a gentle examination of the anal region.
The fissure or tear is usually visible and can be easily diagnosed with a physical examination.
If an underlying condition is suspected, your doctor may suggest other diagnostic tests like anoscopy, flexible sigmoidoscopy, or colonoscopy.
An acute fissure looks like a fresh paper cut, whereas a chronic anal fissure is a deeper tear that may be accompanied by internal/external fleshy growths. Anal fissures are considered to be chronic if they last for more than eight weeks.
Once diagnosed, you can discuss the available treatment options with your doctor.
Over-The-Counter Treatment For Anal Fissures
An anal fissure can ease within a few weeks if you make a few changes that will help in keeping your stool soft.
Over-the-counter (OTC) treatments are also available for treating the symptoms of anal fissures. They include:
- Topical application of nitroglycerine (Rectiv) externally to enhance blood flow to the fissure and promote healing.
- Topical use of anesthetic creams like lidocaine hydrochloride (Xylocaine).
- Botox (Botulinum toxin type A) injection to relax spasms by paralyzing the anal sphincter muscle.
- Blood pressure medications like oral diltiazem (Cardizem) or nifedipine (Procardia) to relax the anal sphincter.
Those with a chronic anal fissure that does not respond to OTC treatments may require surgery. A procedure called lateral internal sphincterotomy (LIS), which involves making a small incision to remove a portion of the anal sphincter muscle, is one of the most commonly used surgeries for chronic fissures.
While surgery is the best option to treat chronic fissures, acute fissures can be easily managed and treated with the help of some natural remedies.
Home Remedies For Managing Anal Fissures
1. Coconut Oil
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The emollient properties of coconut oil can help in keeping the affected area lubricated (1). This makes the passing of stool easier and also promotes the healing of the fissure.
You Will Need
1-2 teaspoons of virgin coconut oil
What You Have To Do
- Apply a little virgin coconut oil to the affected area.
- Leave it on.
- Reapply as necessary.
How Often You Should Do This
You may do this 1-2 times daily.
2. Olive Oil, Honey, And Beeswax
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A mixture of olive oil, honey, and beeswax was observed to help manage the symptoms of itchiness and pain associated with anal fissures (2).
You Will Need
- 1 teaspoon of honey
- 1 teaspoon of olive oil
- 1 teaspoon of beeswax
What You Have To Do
- Mix a teaspoon each of olive oil, honey, and beeswax.
- Apply the mixture to the affected area and leave it on.
How Often You Should Do This
You may do this 1-2 times daily.
3. Aloe Vera
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The soothing and wound-healing properties of aloe vera can help in alleviating pain and bleeding associated with anal fissures. It can also speed up the healing of the fissure (3).
You Will Need
1 teaspoon of aloe vera gel
What You Have To Do
- Extract a little gel from an aloe leaf and whisk it to form a paste.
- Apply the aloe gel to the affected area.
- Leave it on until it dries.
How Often You Should Do This
You may do this 2-3 times daily.
4. Warm Sitz Bath
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A warm sitz bath can help in alleviating inflammation and the burning sensation that often accompany an anal fissure (4).
You Will Need
Warm water (as required)
What You Have To Do
- Clean your bathtub thoroughly.
- Fill it with 3-4 inches of warm (not hot) water.
- Soak in the tub for 15-20 minutes, with your perineum region fully immersed in the water.
- Pat your skin dry. Do not touch the affected area.
How Often You Should Do This
You can do this 1-2 times daily.
5. Flaxseed
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Flaxseed can treat the symptoms of constipation (5). This makes it a great option to ease bowel movements and the symptoms of anal fissures.
You Will Need
½ – 1 tablespoon of powdered flaxseed
What You Have To Do
- Mix flaxseed with a glass of water and drink the mixture.
How Often You Should Do This
You may do this once daily.
Along with these remedies, following a proper diet also helps treat anal fissures and prevents their recurrence.
What Should You Eat To Prevent Anal Fissures?
A fiber-rich and laxative diet can help ease acute anal fissures that are caused by constipation.
Raw fruits, vegetables, and whole-grain bread are associated with a decreased risk of anal fissures. Consuming white bread, bacon, sausages, and sauces thickened with roux is associated with an increased risk of anal fissures (6).
High-fiber fruits like pear, grape, plum, and apple with the peel on can also be used to manage the symptoms of constipation due to their high-fiber content (7).
These diet tips and home remedies can help you manage the symptoms of anal fissures rather easily.
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Frequently Asked Questions
Does surgery cure anal fissures?
Surgery is the best available treatment option for chronic anal fissures that last for eight weeks or more. However, acute anal fissures can be easily managed and reversed by following a fiber-rich diet and the above remedies.
What prescription drugs treat anal fissures?
Prescription drugs that are used to treat anal fissures are nitroglycerine (Rectiv), lidocaine hydrochloride (Xylocaine), Botox (Botulinum toxin type A) injection, and blood pressure medications like oral diltiazem (Cardizem) or nifedipine (Procardia).
How long does it take to heal a fissure?
Acute cases of anal fissures should heal between 4 to 6 weeks. However, chronic anal fissures may take 8 weeks or longer to heal.
What is the best cream for fissures?
One of the most popularly used topical creams for anal fissures is nitroglycerine (Rectiv). This formulation can speed the healing of the anal fissure.
How do you know if a fissure is healing?
You will know that your fissure is healing once the pain and bleeding start easing during your bowel movements.
Why does it feel like razor blades when I poop?
This could be due to an injury to the tissue lining your anus, which is commonly referred to as anal fissures. When the injury is exposed to air, it causes a spasm in the sphincter muscle, thereby causing pain.
What is the difference between hemorrhoids and anal fissures?
As already discussed, an anal fissure is a small tear or open sore that occurs in the skin lining your anus. Hemorrhoids, on the other hand, are swollen veins that surround the tissue of the anal opening. Hemorrhoids are also referred to as piles and often occur as bumps on the skin.
References
- “A randomized double-blind controlled trial comparing extra virgin coconut oil with mineral oil as a moisturizer for mild to moderate xerosis.” Dermatitis, US National Library Of Medicine, National Institutes of Health.
- “The safety and efficacy of a mixture of honey, olive oil, and beeswax for the management of hemorrhoids and anal fissure: a pilot study” Scientific World Journal, US National Library Of Medicine, National Institutes of Health.
- “Effects of Aloe vera cream on chronic anal fissure pain, wound healing and hemorrhaging upon defection: a prospective double blind clinical trial.” European Review for Medical and Pharmacological Sciences, US National Library Of Medicine, National Institutes of Health.
- “Effects of warm water sitz bath on symptoms in post-anal sphincterotomy in chronic anal fissure–a randomized and controlled study.” World Journal of Surgery, US National Library Of Medicine, National Institutes of Health.
- “Dual effectiveness of Flaxseed in constipation and diarrhea: Possible mechanism.” Journal of Ethnopharmacology, US National Library Of Medicine, National Institutes of Health.
- “Diet and other risk factors for fissure-in-ano. Prospective case control study.” Diseases of the Colon & Rectum, US National Library Of Medicine, National Institutes of Health.
- “Epidemiological study: Correlation between diet habits and constipation among elderly in Beijing region” World Journal Of Gastroenterology, US National Library Of Medicine, National Institutes of Health.
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