Why Does Anal Fissure Occur?

Quick answer: An anal fissure is a common health problem in society that can significantly impact individuals’ quality of life. It is defined as small, non-superficial tears in the skin of the anal area. Fissures often cause p The causes of anal fissures include excessive str These factors can lead to small tears in the skin of

Medically reviewed by Op. Dr. Yasir Gözü · General Surgery and Proctology · Last updated: July 20, 2026

An anal fissure is a common health problem in society that can significantly impact individuals’ quality of life. It is defined as small, non-superficial tears in the skin of the anal area. Fissures often cause p

The causes of anal fissures include excessive str These factors can lead to small tears in the skin of the anal area that lacks sufficient elasticity. Symptoms of fissures include severe p

Why Does Anal Fissure Occur?

An anal fissure can be described as small and deep tears in the skin surrounding the anus. This condition typically arises due to excessive stretching during defecation. Physical triggers such as hard stools, chronic constipation or diarrhea, anal sex, or childbirth are among the most common causes. Additionally, prolonged diarrhea or constipation can make bowel movements more difficult, leading to the formation of fissures. These situations str

How Is Anal Fissure Diagnosed?

The diagnosis of anal fissure is typically made through the patient’s symptoms and a physical examination. Patients commonly report sharp p Bleeding is also a frequent symptom, often presenting as bright red blood on toilet paper. Doctors can confirm the diagnosis by carefully examining the anal area and, in some cases, using small instruments to get a better view of the interior of the anus. Occasionally, additional tests may be required to rule out other underlying conditions.

Treatment of Anal Fissure

Treatment for anal fissures varies depending on the severity and duration of symptoms. Initially, a high-fiber diet is recommended to soften the stool and make bowel movements easier. Adequate water intake is also essential. Warm sitz baths can increase blood circulation in the anal area, reducing p P These methods often help many patients heal their fissures.

Methods for Treating Anal Fissures

If conservative methods do not lead to healing, more advanced treatment options may be necessary. Botulinum toxin injections can temporarily paralyze the anal muscles, allowing them to relax and the tear to heal. In more severe or chronic cases, surgical intervention may be required. Lateral internal sphincterotomy, the most commonly performed surgical method, involves cutting a portion of the inner muscle of the anal canal to prevent continuous muscle tension, thereby promoting fissure healing. Each treatment method is recommended by the physician based on what is most suitable for the patient.

Frequently Asked Questions

What causes an anal fissure to form?

An anal fissure typically arises from excessive stretching during defecation, with physical triggers such as hard stools, chronic constipation or diarrhea, anal sex, or childbirth among the most common causes. These factors lead to small tears in the skin of the anal area that lacks sufficient elasticity.

How is an anal fissure diagnosed?

Diagnosis is typically made through the patient's symptoms and a physical examination, with bleeding often presenting as bright red blood on toilet paper. Doctors confirm the diagnosis by carefully examining the anal area, sometimes using small instruments to view the interior of the anus, and occasionally additional tests are needed to rule out other conditions.

What is the first-line treatment for an anal fissure?

Initially, a high-fiber diet is recommended to soften the stool and make bowel movements easier, along with adequate water intake. Warm sitz baths can increase blood circulation in the anal area, and these conservative methods help many patients heal their fissures.

What if conservative treatment doesn't heal my fissure?

If conservative methods do not lead to healing, Botulinum toxin injections can temporarily paralyze the anal muscles, allowing them to relax so the tear can heal. In more severe or chronic cases, surgical intervention may be required.

What is a lateral internal sphincterotomy?

It is the most commonly performed surgical method for anal fissures, involving cutting a portion of the inner muscle of the anal canal. This prevents continuous muscle tension, thereby promoting fissure healing.

Sources

• NHS - Anal fissure
• American Society of Colon and Rectal Surgeons (ASCRS) - fascrs.org

This article is for informational purposes only and does not replace a professional medical consultation. For diagnosis and personalized treatment, please book an appointment.