What Causes Anal Fissures?

Though often dismissed as hemorrhoids, anal fissures are an injury to the sensitive anal tissue. Hemorrhoids may cause anal discomfort, but anal fissures cause severe anal pain during a bowel movement that may last several minutes or a few hours. 

At Midwest Hemorrhoid Treatment Center in Creve Coeur, Missouri, our board-certified family medicine physician, Dr. Betsy Clemens, specializes in treating anorectal conditions like anal fissures. We understand how the pain of an anal fissure can affect your daily life.

Here, we want to share with you some of the common causes of anal fissures and what you can do to ease the discomfort and heal the injury.

About your anal fissure

An anal fissure is a tear in the lining of your anal canal. The anal canal is the very last part of your digestive tract and the opening where your body eliminates stool. 

Anal fissures cause sharp pain during a bowel movement. This pain may linger for several minutes or even a few hours after you go to the bathroom. You may also have blood in your stool or on the toilet paper.

Many people with an anal fissure may withhold stool to avoid the severe, prolonged pain that occurs when they go to the bathroom. Withholding stool causes constipation that creates large, dry, and hard stools that may worsen your anal fissure.

Anal fissures are common and can develop at any age. They may also recur. 

Causes of anal fissures

Trauma to the anal canal causes the tear in the tissue that leads to the anal fissure. In most cases, the trauma occurs during a bowel movement.

You may tear the tissue passing large, hard, or dry stool. Straining during a bowel movement and chronic constipation are also common causes of anal fissures. In addition, ongoing diarrhea may injure the sensitive tissue in the anal canal.

Though not as common as trauma, you may also develop an anal fissure from an underlying medical condition such as inflammatory bowel disease (IBD), an anal tumor, or an infection.

You may also be at risk of developing an anal fissure if you have very tight or spastic anal sphincter muscles, which are the muscles that control the release of stool.

Addressing the cause 

Addressing the underlying cause of your anal fissure is the first step in treatment. Since bowel habits cause and worsen anal fissures, we recommend a high-fiber diet or use of a fiber supplement to soften the stools, improving movement through the anal canal and reducing risk of more damage.

You need 20 to 30 grams of fiber a day to bulk up and soften your stool. However, when adding fiber to your diet we recommend going slowly and drinking plenty of water. Adding too much fiber too quickly may cause constipation and worsen your condition.

Soaking your bottom in a warm tub — known as a sitz bath — may ease your pain and support the healing process. We recommend soaking after a bowel movement, which may reduce the severity and length of the post-BM discomfort. 

It may take several weeks, but nonsurgical interventions heal most anal fissures. Surgery is only recommended for anal fissures that fail to heal or cause severe pain.

Bowel habits are responsible for many of the painful conditions that affect the last section of your gastrointestinal tract. Don’t ignore your anal pain; we can help. Call our office at 636-228-3136 to schedule an appointment today.