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What is Anal fissure?

An anal fissure is a tear in the lining of the anus. It can cause severe pain during and after a bowel movement. The pain can last several minutes to several hours, and can recur with each bowel movement. Traces of bright red blood on the surface of the stool or on the toilet paper may also be present.

Anal fissures can make having a bowel movement (pooping) very painful. The pain may make it hard for you to have a bowel movement, causing constipation (having fewer bowel movements than usual). They can also cause bleeding from your anus.

Causes of Anal Fissures

The most common cause of anal fissures is injuring the lining of your anus. This can happen when you:

• Have large bowel movements (poop)
• Have hard, dry bowel movements
• Have diarrhea (loose or watery bowel movements)
• Are constipated
• Strain or use force during your bowel movements
• Give birth
• Have anal sex

Anal fissure symptoms

The most common symptoms of anal fissures are:

• A sharp pain when you poo, often followed by a deep burning pain that may last several hours
• Visible tear or cut in the area
• Bright red bleeding during or after a bowel movement

Fissures result from the stretching of your anal mucosa beyond its normal capacity. This often happens when stools are hard due to constipation. Once the tear happens, it leads to repeated injury. The exposed internal sphincter muscle beneath the tear goes into spasm. This causes severe pain. The spasm also pulls the edges of the fissure apart, making it difficult for your wound to heal. The spasm then leads to further tearing of the mucosa when you have bowel movements. This cycle leads to the development of a chronic anal fissure in approximately 40% of patients.