Anal Fissures

What are anal fissures?

Fissures are cracks in the anal skin caused by small or hard bowel movements. Diarrhea can also cause fissures by drying out the skin until it cracks open (just as dish water can cause cracks in the skin of the hands).

illustration of an anal fissure

Since anal skin is very sensitive, these cracks can cause severe pain. They can also cause rectal bleeding. The pain and bleeding is worse after bowel movements. Usually, the bleeding is bright red.

Occasionally, fissures are very large, ugly and raw. In this case, they may be due to Crohn's disease, an inflammation of the lining of the colon.

Treatment

Natural vegetable powder will cure at least half of all fissures. If the pain is extremely bad, or if the fissures do not disappear as a result of fiber therapy, they can be cured by simple outpatient surgery.

In this surgery, a small quarter inch to one-half inch incision is made in the anal skin near the anal fissure. The incision is made over the internal anal sphincter muscle. Once the incision is made in the skin, some of the muscle fibers of the internal sphincter are divided. This releases the tension off of the skin at the anal fissure. This allows the fissure to heal as the skin closes. If swollen skin and scar tissue are present at the fissure, these may also be removed. Individuals can usually be back to work two to ten days after their surgery.