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Understanding the condition
An anal fissure is a tear in the lining of the anal canal. It often causes sharp pain during or after bowel movements and a small amount of bright-red bleeding. It is frequently mistaken for hemorrhoids.
What the evaluation looks for
Examination and the pattern of symptoms help establish the diagnosis. Unusual, persistent or recurrent lesions may need evaluation for another condition.
How treatment is chosen
Treatment often begins with measures to keep stool soft and reduce irritation. Prescribed topical treatment or botulinum toxin may help a persistent fissure. Surgery can be effective in selected patients, but the effect on continence must be considered, especially with prior injury or bowel-control problems.
Questions worth asking
- Is this an acute or chronic fissure?
- What should I do if the first treatment does not work?
- How does my continence history affect the options?
When to seek help promptly
Fever, swelling, drainage or escalating pain may indicate another problem such as an abscess and needs prompt evaluation.