What Causes Chronic Anal Fissure?

Chronic anal fissure refers to long-term tears in the inner part of the anal canal, usually presenting with severe pain during defecation. The main feature is that the tear fails to heal within six to eight weeks.

Bowel Problems and Constipation

Constipation is one of the most common causes of chronic anal fissures. Hard and strained bowel movements damage the lining. Irregular bowel movements lead to hardened stool and increased pressure on the anal region during defecation.

The Effect of Chronic Diarrhea on Anal Fissure

Frequent episodes of diarrhea can disrupt the mucosal integrity of the anal canal due to continuous irritation, paving the way for fissure formation. Inconsistencies in stool consistency make it harder to protect the anal area.

Improper Toilet Habits

Prolonged sitting on the toilet and excessive straining are common triggers. Additionally, unnecessary straining during bowel movements keeps the tear open.

Excessive Tension in Anal Muscles

Spasms of the internal anal sphincter create high pressure in the anal canal, making healing difficult. Chronic stress and muscle tension can also lead to excessive contraction of the sphincter, contributing to the chronicity of anal fissures.

Inflammation and Infections

Localized infections and chronic inflammation can prevent anal fissures from healing over time. In particular, fungal and bacterial infections can increase tissue sensitivity in the anal region, triggering fissure formation.

Poor Diet and Nutritional Deficiencies

A lack of fiber and insufficient water intake can disrupt bowel regularity, increasing the risk of constipation. Adequate fiber and water consumption are essential for a healthy digestive system. To learn more about dietary recommendations for anal fissure patients, check out our article on how anal fissure patients should eat.

Pregnancy and Postpartum Anal Fissure

Pressure applied to the perineal area during childbirth can cause anal fissures. Postpartum rectal injuries may also make healing more difficult.

Chronic Diseases and Immune System Disorders

Crohn’s disease and inflammatory bowel diseases can increase the sensitivity of the anal mucosa, contributing to the formation of fissures.

Sources and References

• NHS - Piles (haemorrhoids)
• NIDDK - Hemorrhoids