BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAnal fissureFissure in ano; Anorectal fissure; Anal ulcerAn anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).MucosaMucosa is moist tissue that lines certain parts of the inside of your body. It is in your: NoseMouthLungsDigestive tractUrinary and genital tracts G...ImageRead Article Now Book Mark Article Causes Anal fissures are very common in infants, but they may occur at any age.In adults, fissures may be caused by passing large, hard stools, or having diarrhea for a long time. Other factors may include:Decreased blood flow to the area Too much tension in the sphincter muscles that control the anus The condition affects males and females equally. Anal fissures are also common in women after childbirth and in people with Crohn disease.Crohn diseaseCrohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...ImageRead Article Now Book Mark Article Symptoms An anal fissure can be seen as a crack in the anal skin when the area is stretched slightly. The fissure is almost always in the middle. Anal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet paper (or baby wipes) after a bowel movement.Symptoms may begin suddenly or develop slowly over time. Exams and Tests The health care provider will perform a rectal exam and look at the anal tissue. Other medical tests that may be done include:Rectal examA digital rectal exam is an exam of the lower rectum. Your health care provider uses a gloved, lubricated finger to check for any abnormal findings....ImageRead Article Now Book Mark Article Anoscopy -- examination of the anus, anal canal, and lower rectum AnoscopyAnoscopy is a method to look at the: AnusAnal canalLower rectumImageRead Article Now Book Mark Article Sigmoidoscopy -- examination of the lower part of large intestine SigmoidoscopySigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest to the re...ImageRead Article Now Book Mark Article Biopsy -- removal of rectal tissue for examination BiopsyA rectal biopsy is a procedure to remove a small piece of tissue from the rectum for examination.ImageRead Article Now Book Mark Article Colonoscopy -- examination of the colonColonoscopyA colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope. The colonoscope has a sm...ImageRead Article Now Book Mark Article Treatment Most fissures heal on their own and do not need treatment.To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently.CHILDREN AND ADULTSWorrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make the anal fissure worse.Prevent hard stools and constipation by:Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains BulkFiber is a substance found in plants. Dietary fiber, which is the type of fiber you can eat, is found in fruits, vegetables, and grains. It is an i...ImageRead Article Now Book Mark Article Drinking more fluids Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin:Numbing cream, if pain interferes with normal bowel movements Petroleum jelly Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks.Sitz bathA sitz bath is a warm water bath used for healing or cleansing purposes. You sit in the bath. The water covers only your hips and buttocks. The wa...ImageRead Article Now Book Mark Article If the anal fissures do not go away with home care methods, treatment may involve:Botulinum toxin injections into the muscle in the anus (anal sphincter) Minor surgery to relax the anal muscle Prescription creams, such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles Outlook (Prognosis) Anal fissures often heal quickly without any more problems.People who develop fissures once are more likely to have them in the future.Open ReferencesReferencesDowns JM, Kulow B. Anal diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 129.Hyman N, Omanskiy K. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 53.Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 371.AllVideoImagesTogRectum - illustration The rectum is the final portion of the large intestine. It empties stool from the body through the anus. RectumillustrationAnal fissure - seriesPresentation Rectum - illustration The rectum is the final portion of the large intestine. It empties stool from the body through the anus. Rectumillustration Anal fissure - seriesPresentation Related Information Mucosa(Special Topic)Constipation in infants and children(Symptoms)Crohn disease(Condition)Chronic(Special Topic)Crohn disease - InDepth(In-Depth) Review Date: 4/20/2022 Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. 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Anal fissureFissure in ano; Anorectal fissure; Anal ulcerAn anal fissure is a small split or tear in the thin moist tissue (mucosa) lining the lower rectum (anus).MucosaMucosa is moist tissue that lines certain parts of the inside of your body. It is in your: NoseMouthLungsDigestive tractUrinary and genital tracts G...ImageRead Article Now Book Mark Article Causes Anal fissures are very common in infants, but they may occur at any age.In adults, fissures may be caused by passing large, hard stools, or having diarrhea for a long time. Other factors may include:Decreased blood flow to the area Too much tension in the sphincter muscles that control the anus The condition affects males and females equally. Anal fissures are also common in women after childbirth and in people with Crohn disease.Crohn diseaseCrohn disease is a disease where parts of the digestive tract become inflamed. It most often involves the lower end of the small intestine and the be...ImageRead Article Now Book Mark Article Symptoms An anal fissure can be seen as a crack in the anal skin when the area is stretched slightly. The fissure is almost always in the middle. Anal fissures may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet paper (or baby wipes) after a bowel movement.Symptoms may begin suddenly or develop slowly over time. Exams and Tests The health care provider will perform a rectal exam and look at the anal tissue. Other medical tests that may be done include:Rectal examA digital rectal exam is an exam of the lower rectum. Your health care provider uses a gloved, lubricated finger to check for any abnormal findings....ImageRead Article Now Book Mark Article Anoscopy -- examination of the anus, anal canal, and lower rectum AnoscopyAnoscopy is a method to look at the: AnusAnal canalLower rectumImageRead Article Now Book Mark Article Sigmoidoscopy -- examination of the lower part of large intestine SigmoidoscopySigmoidoscopy is a procedure used to see inside the sigmoid colon and rectum. The sigmoid colon is the area of the large intestine nearest to the re...ImageRead Article Now Book Mark Article Biopsy -- removal of rectal tissue for examination BiopsyA rectal biopsy is a procedure to remove a small piece of tissue from the rectum for examination.ImageRead Article Now Book Mark Article Colonoscopy -- examination of the colonColonoscopyA colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope. The colonoscope has a sm...ImageRead Article Now Book Mark Article Treatment Most fissures heal on their own and do not need treatment.To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently.CHILDREN AND ADULTSWorrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make the anal fissure worse.Prevent hard stools and constipation by:Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains BulkFiber is a substance found in plants. Dietary fiber, which is the type of fiber you can eat, is found in fruits, vegetables, and grains. It is an i...ImageRead Article Now Book Mark Article Drinking more fluids Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin:Numbing cream, if pain interferes with normal bowel movements Petroleum jelly Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks.Sitz bathA sitz bath is a warm water bath used for healing or cleansing purposes. You sit in the bath. The water covers only your hips and buttocks. The wa...ImageRead Article Now Book Mark Article If the anal fissures do not go away with home care methods, treatment may involve:Botulinum toxin injections into the muscle in the anus (anal sphincter) Minor surgery to relax the anal muscle Prescription creams, such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles Outlook (Prognosis) Anal fissures often heal quickly without any more problems.People who develop fissures once are more likely to have them in the future.Open ReferencesReferencesDowns JM, Kulow B. Anal diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 129.Hyman N, Omanskiy K. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 53.Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Surgical conditions of the anus and rectum. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 371.