Fissures

What Causes an Anal Fissure?
An anal fissure is a small tear in the lining of the anus, most often caused by straining during bowel movements or passing hard or large stools. Other causes include constipation, chronic diarrhea, childbirth, and anal intercourse. In some cases, repeated fissures may be linked to underlying conditions such as inflammatory bowel disease or infection.

Symptoms
Common symptoms include:

• Sharp pain during or after bowel movements
• Bright red blood on toilet paper or stool
• Burning or itching around the anus
• A small tear or lump near the anal opening

Diagnosis
Anal fissures are usually diagnosed during a simple physical exam. If a fissure appears in an unusual location or does not heal, additional testing may be recommended to rule out other conditions. Please refer to your general practitioner to see if you are a candidate for a referral to us for treatment.

Treatment
The majority of anal fissures heal with conservative care. Treatment focuses on reducing pain, relaxing the anal muscles, and making bowel movements easier. This may include stool softeners, increased fiber and water intake, warm sitz baths, and topical medications to relieve pain and promote healing.

If a fissure does not heal or causes ongoing pain, additional treatments may be recommended to relax the anal sphincter. One option may be Chemical Sphincterotomy with Botox™, this is a minor surgical procedure involving injection of Botox™ into the internal anal sphincter. Another option may be Lateral Internal Sphincterotomy. This minor surgical procedure involves making a small incision in the internal anal sphincter muscle to relieve tension. Reducing this pressure allows the fissure to heal and helps prevent recurrence. The procedure is highly effective and typically provides lasting relief.