Anal Fissures

An anal fissure is a cut or a tear in the thin, delicate lining of the anus. The tear often exposes the muscle around the anus, called the anal sphincter. This exposure can trigger the muscle to spasm, which can pull apart the edges of the fissure even further. This progression can cause more severe pain and delay healing. Contact with passing stools can also slow down the healing process.

Who Gets Anal Fissures?

Anal fissures are very common, although people may often assume the pain and bleeding are symptoms of other conditions, such as hemorrhoids. They are equally common among men and women. They are also common in infants.

Adults between 20 and 40 are thought to be most likely to develop anal fissures. But an anal fissure can occur at any age, even though the risk generally decreases with age.

Anal fissures are seen more often with certain medical conditions, such as:

• anal cancer
• leukemia
• STDs and HIV
• complications from other medical conditions, such as Crohn’s or ulcerative colitis

Why Do People Get Anal Fissures?

An anal fissure is caused by trauma or injury that stretches the anal canal. This can result from a number of issues, such as:

• constipation, or passing large or hard stool
• explosive or prolonged diarrhea
• childbirth

Less frequently, having anal sex or inserting foreign objects into the anus can over-stretch the skin and result in a fissure.

Too much pressure, tight anal sphincter muscles, and poor blood supply to the anus may contribute to the development and poor healing of anal fissures.  

Anal fissures do not typically lead to more serious problems, and they certainly don’t cause cancer. But they can be quite uncomfortable. Avoiding constipation, practicing good bowel habits, and maintaining a healthy diet are all important for helping anal fissures heal and preventing future occurrences.