-
24/7 available services
-
Anal fissure is a small tear in the anoderm causing severe pain with defecation. Usually at posterior midline. Caused by hard stools, chronic constipation, or trauma. Common in young adults and postpartum women. Often self-limited but may become chronic.
Diagnosis: Clinical examination. Anoscopy if diagnosis unclear.
Lateral Internal Sphincterotomy: Gold standard for chronic fissure. Divides internal sphincter fibers. Minimal incontinence risk. 95%+ success rate.
Surgical recovery: 1-2 weeks. Pain relief immediate. Return to normal activities 2-3 weeks. Recurrence rate <5% with LIS. Most patients achieve complete healing.
An anal fissure is a small tear in the thin lining of the anal canal. Most fissures start when a hard or large stool stretches the anus beyond what the lining can tolerate. Repeated straining, long-standing constipation and, less commonly, frequent loose motions can all cause or reopen a tear.
Once a tear forms, the internal anal sphincter muscle often goes into spasm. The spasm reduces blood flow to the tear and keeps it from healing, which is why some fissures become long-lasting (chronic) even though they started as a small injury.
The typical symptom is sharp pain while passing stool, often described as "passing glass", followed by a burning or throbbing ache that can last from a few minutes to a few hours. Many people also notice a small amount of bright red blood on the tissue paper or on the surface of the stool.
An acute fissure is recent, usually less than six weeks old, and looks like a fresh, clean tear. Most acute fissures heal with diet changes, stool softeners and local treatment. A chronic fissure has lasted longer than six to eight weeks. It may have raised edges, a skin tag and exposed muscle fibres at its base, and it is less likely to heal without specific treatment to relax the sphincter.
In most cases the doctor can diagnose a fissure by gently looking at the area during an outpatient visit. Because the area is very tender, an internal examination is usually avoided at the first visit. If the fissure is in an unusual position, does not heal, or if there are other symptoms such as weight loss or a change in bowel habit, your surgeon may advise further tests such as proctoscopy or colonoscopy to rule out other conditions.
Treatment aims to soften the stool, relieve pain and relax the sphincter muscle so that the tear can heal.
See a doctor if you have pain or bleeding when passing stool that does not settle within a week or two, if bleeding is heavy, or if you also have fever, discharge, weight loss or a change in bowel habit. Bleeding from the back passage can have causes other than a fissure, so it should always be checked.
Many acute fissures heal within a few weeks with softer stools, sitz baths and ointments. Chronic fissures are less likely to heal without treatment aimed at relaxing the sphincter muscle.
No. Piles (haemorrhoids) are swollen blood vessels, while a fissure is a tear in the lining. Both can cause bleeding, but a fissure typically causes sharp pain during bowel movements. A doctor's examination tells them apart.
Sphincterotomy is planned to relax only part of the internal sphincter. Your surgeon will explain the small risk of minor leakage and whether you are a suitable candidate.
Anal fissure treatment at Charak Hospital — from conservative and topical therapy to lateral internal sphincterotomy (LIS) for chronic fissures — is provided by Dr. Ashok Kumar, Senior Consultant Surgical Gastroenterologist — MCh Surgical Gastroenterology (SGPGI), FRCS, FACS, FASCRS, with 25+ years of experience.
Book Appointment: 0522-666-4444 View Dr. Ashok Kumar's profile →
Book a consultation: call 0522-666-4444 or use the request call back form on this page. In an emergency, come straight to the 24/7 emergency department at Charak Hospital, Hardoi Road, Dubagga, Lucknow.