Anal fissure

An anal fissure, or anal tear, is a deep tear in the delicate mucous membrane of the lower anal canal.
A primary anal fissure develops due to inflammation or injury, such as from passing very hard stools or anal intercourse. Secondary anal fissures occur as a result of underlying conditions, such as Crohn's disease or ulcerative colitis.

People who suffer from primary anal fissures experience intense anal pain, especially during bowel movements, which can persist for several hours afterwards. Blood is often visible on the toilet tissue or in the stool. In some cases, the intense pain from anal fissures can trigger spasms in the sphincter muscle, which can also be extremely painful.

Secondary anal fissures resulting from an underlying condition such as Crohn's disease or ulcerative colitis usually cause less severe pain. However, in this case as well, increased muscle tone can lead to sphincter spasms.

If left untreated, an anal fissure can sometimes develop into a chronic condition.

To relieve pressure on the tissue in the rectum, it is advisable to soften the stool with a high-fibre diet, adequate fluid intake and, if necessary, a supplementary remedy. The symptoms of an anal fissure can also be relieved with ointments, suppositories and medical wipes containing anti-inflammatory or pain-relieving ingredients such as lidocaine, camphor and menthol. Some people with anal fissures find relief from home remedies like chamomile sitz baths.

If an anal fissure does not heal, it is advisable to consult a specialist (proctologist).

In the case of primary anal fissures, the anal mucosa is usually already irritated or slightly damaged, leading to tears when triggered by:

• Hard stools and constipation, resulting in straining
• Diarrhoea irritates the sensitive anal skin
• High muscle tension in the sphincter muscle
• Unprepared anal intercourse
• Inflammation in the rectum

Secondary anal fissures are more likely to occur in the presence of underlying conditions:

• Crohn's disease and ulcerative colitis
• Infectious diseases:
  • Syphilis
  • Tuberculosis
  • Leishmaniasis
  • HIV/ Aids
  • Certain herpes viruses
  • Cytomegaly
• Leukaemia
• Cow's milk allergy
• Behçet's disease (rheumatic disease of the blood vessels)
• Narrowing of the anal canal

Surgery in the rectal area also increases the risk of anal fissures.