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Fissures are tears in the lower lining of the rectum that cause severe pain during a bowel movement. Fissures are common, and typically do not lead to more serious health concerns. The majority of anal fissures heal in a matter of days or a few weeks. Chronic fissures, which last six weeks or more, may require visiting a health care professional for assistance. Fissures affect people of all ages and occur equally in men and women. To learn more about fissures, please contact Central Florida Hepatology & Gastroenterology at 407.303.1812 or request an appointment on our website.                                                                                                                                 

Symptoms of Fissures

Anal fissures cause a variety of painful and uncomfortable symptoms such as:

  • Painful bowel movements consisting of burning and stinging sensations. The pain may be brief or last up to several hours after the bowel movement is complete.
  • Itching and burning
  • Bleeding caused by the tear in the rectum. Blood can be seen on the stool or on the toilet paper.

Causes of Fissures

There are several causes of fissures. Common causes include:

  • Passing a large stool that tears the anal canal
  • Attempting to pass a hard stool due to constipation
  • Having bouts of repeated diarrhea

Childbirth is also a common cause of fissures in women. Fissures can develop during labor due to the constant pushing and anal trauma resulting from childbirth. They can also develop after a rectal exam or anal intercourse.

In some instances, fissures are caused by intestinal conditions like Crohn’s disease, and inflammatory bowel disease resulting in frequent diarrhea and fistulas near the anal canal.

Some health care experts believe there are other causes of fissures. While all people experience diarrhea and constipation, not all people develop fissures. Experts surmise that some individuals have increased tension in the internal sphincter leading to pressure that causes a fissure to develop. 

Treatment for Fissures

The majority of fissures heal within 4-6 weeks. Painful bowel movements are common during the first few days, but typically subside. A fissure that does not heal within six weeks is considered a chronic problem that requires medical treatment.

Physicians will generally prescribe medications in an attempt to heal the fissure using the least invasive method. The most common medication used is nitroglycerin cream applied to reduce pressure in the internal sphincter.

When less invasive treatment options fail, surgery may be required. The surgery involves a small incision made in the internal sphincter causing a reduction in pressure. Even when surgery is done, the fissure must heal on its own.

To learn more about fissures, please contact Central Florida Hepatology & Gastroenterology at 407.303.1812 or request an appointment on our website.