Harvard Women's Health Watch

Ask the doctor: What can I do about an anal fissure?

Ask the doctor

What can I do about an anal fissure?

Q. I had pain and some bleeding during bowel movements. My doctor says it's an anal fissure. What is that, and what's the best way to treat it?

A. An anal fissure is a tear in the tissue that lines the anal canal, usually resulting from trauma, such as the passage of hard stool. It causes sharp, tearing pain while passing a bowel movement, often accompanied by a small amount of blood on the toilet tissue or surface of the stool. Anal fissures are common and can easily become chronic, because after the first tear, bowel movements reinjure the area. The sphincter muscle beneath the tear goes into spasm, pulling the edges of the tear apart. A cycle of spasm and pain further damages the tissue and prevents healing.

Simple home remedies can help. It's important to relax the anal sphincter and keep stools soft and regular. The mainstay of therapy is added fiber in the diet (fruits and vegetables are good sources) or from a supplement such as psyllium (Metamucil) or methylcellulose (Citrucel). Plenty of fluid is also important. If fiber and fluid don't do the trick, try an over-the-counter stool softener. To help relax the sphincter and relieve pain, take a warm sitz bath after bowel movements. Vaseline (petroleum jelly) may also ease your symptoms.

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