Anal Fissure

Common Symptoms of an Anal Fissure

The signs of an anal fissure can be mistaken for hemorrhoids, but there are key differences. Typical symptoms include:

• Severe pain during and even more after defecation (often described as a tearing or burning sensation like “passing razor blades or glass”)
• Bright red blood on toilet paper or on the top of the stool
• A visible small crack or tear in the skin around the anus
• Spasms in the anal muscles, making bowel movements even more painful
• Itching or irritation around the anal area
• Fear of having bowel movements due to pain

If you experience ongoing pain or bleeding, it’s important to see a proctologist or gastroenterologist for proper diagnosis and treatment.

What Causes Anal Fissures?

Anal fissures usually happen when the anal lining is stretched too much or too quickly. Common causes include:

• Passing hard or large stools due to constipation
• Chronic diarrhea or frequent bowel movements
• Straining during bowel movements
• Childbirth, which can cause tearing in the anal tissue
• Inflammatory bowel disease (IBD) such as Crohn’s disease
• For atypical fissures there is a small chance for anorectal manifestation of Crohn’s disease, HIV or even anal carcinoma.
• Tight anal sphincter muscles, which reduce blood flow and delay healing

Fissures are often self-diagnosed as hemorrhoids. In case of symptoms, do not self-medicate but seek an expert opinion.

You can help the healing process by:

• Keeping stools soft with a high-fiber diet and plenty of fluids
• Avoiding straining during bowel movements
• Using warm sitz baths with EPSOM salt (soaking the area in warm water for 5-10 minutes) several times a day to relieve pain
• Applying prescribed creams or ointments, such as topical anesthetics or muscle relaxants, to reduce discomfort and help the fissure heal
• Maintaining good hygiene, gently cleaning and drying the area with soft cotton towel
• Use rather “shattaf” or bidet, then dry the area with soft towel - instead of toilet paper or wipe, because those can cause more irritation

Medical Treatments for Anal Fissure

Patients need to come to see us either with acute onset of symptoms or even when they are chronic. At Mubadala Health Dubai, our multidisciplinary team of gastroenterologists and surgeons ensures compassionate, precise, and effective care tailored to each patient’s condition.

Options include:

• Topical nitroglycerin or calcium channel blocker creams: to relax the anal muscles and improve blood flow
• Botox injections: to temporarily relax the sphincter muscles and allow healing
• Laser anal fissurectomy: to improve wound healing
• Anal dilatation, examination under anesthesia, biopsy
• Advancement flaps
• Lateral internal sphincterotomy (LIS): a small surgical cut to reduce pressure in the anal canal, often recommended for chronic cases

When to See a Doctor

Seek medical advice if you have:

• Acute onset of severe anal pain and bleeding
• Persistent pain or bleeding after bowel movements
• Chronic constipation or diarrhea that keeps causing new fissures
• Signs of infection, such as swelling, discharge, or fever

An anal fissure can be painful, but with the right treatment and early intervention, most patients may recover fully without surgery. But recurrence might still happen if the underlying cause is still persisting.

If you’re experiencing symptoms, consult a specialist in proctology or gastroenterology at Mubadala Health Dubai for accurate diagnosis and gentle, expert care.