The Most Common Causes of Anal Fissures

At Midwest Hemorrhoid Treatment Center in St. Louis, Missouri, our board-certified family physician, Dr. Betsy Clemens, knows how uncomfortable it can be to talk to your doctor about things like anal pain. But millions of people in the United States experience this type of pain, which may occur for a wide range of reasons, and it’s nothing to be embarrassed about. One of the most common causes is an anal fissure, which refers to a crack or tear in the delicate tissue.

If you have a history of anal fissures, you’re at greater risk of a recurrence. Knowing more about the common causes of anal fissures may prevent another painful tear, or eliminate the development of the uncomfortable anal injury in the first place. 

About your anal fissure

Your anal canal is a short, muscular tube located at the end of your rectum. During a bowel movement, the anal sphincter muscles relax to allow stool to exit your rectum. An anal fissure is a crack or tear in the delicate mucosal tissue that lines your anal canal. 

With an anal fissure, you may experience sharp, shooting pain in the anus and surrounding area. The fissure may also cause severe discomfort and bleeding during a bowel movement, and, at times, it can be itchy. 

Anal discomfort, blood in the toilet after a bowel movement, and anal itching are also the same symptoms you may experience with hemorrhoids, and like many people, you may self-diagnose your symptoms incorrectly.

However, whether your symptoms are caused by an anal fissure or hemorrhoids, you should never disregard them, especially if your symptoms include blood in your stool. That’s why it’s important to see your doctor. We specialize in rectal disorders like anal fissures and can diagnose and treat your condition to alleviate your discomfort and prevent further complications.

Most common causes of anal fissures

Anal fissures are often caused by trauma to the delicate mucosal tissue. You may develop the painful tear after passing large or hard stools. Straining during a bowel movement may also traumatize the delicate tissue and cause tearing. In addition, chronic diarrhea and anal intercourse often lead to fissures. 

You may also be at greater risk of developing an anal fissure as you get older, too, due to a decrease in blood flow to the area. Anal fissures may also occur in women during childbirth.

Though not as common, fissures can develop if you have a history of inflammatory bowel disease (Crohn’s disease), HIV, syphilis, or tuberculosis. 

Treatment for your anal fissures

Anal fissures may only take a few weeks to heal with the right care. To minimize tissue strain and further trauma, we recommend upping your intake of fiber-rich foods and drinking more water to help soften your stools and improve bowel movements. Soaking in a sitz bath a few times a day for 10–20 minutes also supports healing by helping the sphincter muscle to relax. 

If your anal fissure fails to heal within eight weeks of at-home care, then you may have a chronic fissure that requires further medical intervention, such as Botox® injections to relax the sphincter or surgery to stop muscle spasms and pain.  

Anal fissures are uncomfortable, but they’re both treatable and avoidable. For comprehensive care from a physician who specializes in rectal disorders, call the office at 636-228-3136 to make an appointment today.