Anal Fissure: Signs and Symptoms

Anal Fissure: Signs and Symptoms


An anal fissure is a tear in the lining of the anus. The tear can cause pain and bleeding when defecating (pooping). You may develop an anal fissure when you are constipated and trying to pass a hard stool. People who experience constipation regularly are more likely to experience anal fissures. However, the tears can also be caused by diarrhea, pregnancy, sexually transmitted infections (STIs), or anal penetration.

When you develop an anal fissure, the symptoms of pain and blood may develop suddenly or gradually. Anal fissures and their symptoms may last less than six weeks (acute anal fissures) or longer than six weeks (chronic anal fissures). Typically, chronic anal fissures are acute anal fissures that keep occurring.

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Both acute and chronic anal fissures are characterized by rectal pain and rectal bleeding.

The pain usually occurs as you are making a bowel movement—as the stool is passing out your anus. The pain can be sharp and severe. The pain may continue for a few hours after pooping, and it might feel like your anus is burning or itching.

The anal tissue may feel so tender that you are unable to have anything inserted into your anus, including a healthcare provider’s gloved finger during a rectal exam.

You may also notice bright red blood in your poop, on the toilet paper, or in the toilet water once you’ve completed your bowel movement.

Anal fissures can be defined as acute (lasting less than six weeks) or chronic (lasting longer than six weeks). Generally, acute fissures resolve quickly, but fissures that don’t completely heal can potentially become chronic.

Acute Symptoms

The tear caused by an acute anal fissure may be more superficial (surface-level) than tears from chronic fissures. Acute anal fissures generally heal quickly, so symptoms may not last as long or be as severe. While they can be painful, you might not always notice bleeding with these shorter-lasting tears.

Chronic Symptoms

With chronic anal fissures, the tear may be deeper and larger—to the point that muscle fibers may be exposed. It’s possible for the edges of the anal tissue to look raised. Sentinel piles, or skin tags, can also develop. These occur when the tissue at the end of the tear thickens.

Anal fissures can happen to someone of any age, including babies and children. The tears are especially common among infants. If you care for a baby or child, be on the lookout for symptoms of anal fissures.

Symptoms among babies and children are similar to those experienced by adults. You might notice rectal bleeding, a tear in the anal tissue, and tenderness or swelling of anal tissue. Nine in 10 cases of blood in children’s stool are due to anal fissures.

If you notice your child seems to be going to the bathroom less often, consider asking them why that is. Sometimes, people may hold in their poop to avoid the pain that bowel movements cause. Your child may reveal that they are going less often because it hurts them to go—a sign of an anal fissure.

Most anal fissures heal on their own without medical treatment.

If your pain or bleeding doesn’t resolve or become severe, it’s important to reach out to your healthcare provider. They can confirm that it’s an anal fissure causing your symptoms and help you determine next steps for treatment. They can also give some advice on how to prevent recurrence of acute anal fissures or chronic fissures.

Anal fissures are small tears in the anus that can cause anal pain and bleeding. The pain can be sharp and severe as you make a bowel movement and linger for an hour or two afterward. Your anus may also feel itchy. You may see the blood on your stool, in the toilet bowl, or on the toilet paper after you wipe.

Although painful and uncomfortable, most fissures resolve on their own within a few days to a few weeks. Your healthcare provider can recommend treatment for severe or long-lasting cases. 

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