In the infinity of life where I am, all is perfect, whole, and complete. – Louise L. Hay

What is fissure?

An anal fissure is a small tear in the thin, moist tissue that lines the anus and may occur when you pass hard stools during a bowel movement. It can bleed and make bowel movements very painful. Sometimes the pain lasts for hours after you've gone to the bathroom.

Possible Causes: 

An anal fissure is a small cut or tear in the lining of the anus. This causes pain and some bleeding during and after bowel movements. At times, the fissure can be deep enough to expose the muscle tissue underneath. Trauma or injury to the anal canal due to any of the following reasons may cause anal fissures:

  • The most common cause of this condition is passing hard or large stools.
  • Constipation or diarrhoea can tear the skin around the anus.
  • Inflammatory Bowel Disease (IBD)
  • Straining during childbirth.
  • Decreased blood flow to that region.
  • Tight sphincter muscles.
  • Sometimes haemorrhoid fissures may be related to other conditions such as anal cancer, HIV, TB, herpes or syphilis.

Risk Factors: 

Persons between the age of 20 and 40, both men and women, are likely to suffer from anal fissures. Certain medical conditions such as Crohn’s Disease, anal cancer, leukaemia, STDs and HIV may also suffer from anal fissures.

Signs & Symptoms: 

The main symptom of anal fissures is pain during and following bowel movements. Other symptoms could be bleeding, itching, or a discharge that smells foul. You may notice a small lump of skin near the tear.


At Medcare, the doctor will diagnose an anal fissure during a visual exam. Further tests may be suggested in order to know whether there is any other underlying condition. This testing could be done by anoscopy or flexible sigmoidoscopy or colonoscopy.

Treatment Options: 

Schedule a consultation at Medcare to know the best fissure treatment options for you and how to cure fissures permanently. Fissure treatment without surgery may include certain medications to be taken orally or applied locally. These help to reduce the pain and relax the anal sphincter. In some cases, Botox® injections are prescribed in order to paralyse the anal sphincter muscle and relax the spasm.

If you have a chronic anal fissure or if the symptoms are very severe, then your doctor may suggest surgery. The procedure is called lateral internal sphincterotomy (LIS). A small portion of the anal sphincter muscle is cut to reduce spasm and pain and promote healing.

Observe the signs that a fissure is healing and schedule follow up consultations as recommended.

FAQs: الأسئلة الشائعة:
  • How can I prevent anal fissures?

    A: Many of the precautions to prevent anal fissures are similar to the prevention of haemorrhoids. Eat plenty of fibre and drink enough water so you can avoid being constipated. Exercise regularly to keep your digestion moving and your weight under control. If you have the urge to have a bowel movement, don’t delay it.

  • Can anal fissures heal on their own?

    A: Yes, for some people, anal fissures heal on their own within a few weeks. You should keep your stools soft by eating more fibre and drinking more fluids. Soaking in warm water for 10 to 20 minutes, several times a day, helps to relax the sphincter muscles and enables healing.

  • How do Botox® injections help anal fissures?

    A: Botox® injections are used to treat chronic and acute anal fissures. These temporarily paralyse the sphincter muscle, relieve pain and encourage healing in 60% to 80% of patients.