Anal fissures are cracks in the inner lining of the anus or anal canal (the opening through which stool passes out of the body). These cracks can cause bleeding and severe pain.

Who is at Risk for Anal Fissures?

Anal fissures can occur in individuals of any age. The likelihood of developing anal fissures decreases with age, but individuals who have had anal fissures in the past are more likely to experience them in later years.

What are the Symptoms of an Anal Fissure?

Some common symptoms of an anal fissure include:
– Pain during or after bowel movements that can last for hours,
– Constipation,
– Blood on the surface of the stool,
– Blood on toilet paper,
– Visible crack or tear in the anus or anal canal,
– Painful itching and burning,
– Difficulty urinating, frequent urination, or inability to urinate,
– Foul-smelling discharge.

What Causes an Anal Fissure?

Anal fissures can occur due to external trauma to the anus and anal canal. For example:
– Chronic constipation,
– Straining during bowel movements, especially with large, hard, and/or dry stools,
– Prolonged diarrhea,
– Anal sex or anal stretching,
– Insertion of foreign objects into the anus.

Causes other than trauma include:
– Overly tight or lax anal sphincter muscles (muscles that control the closing of the anus),
– Scar tissue in the anorectal area,
– Underlying medical conditions such as Crohn’s disease, ulcerative colitis, anal cancer, leukemia, infectious diseases (e.g., tuberculosis), sexually transmitted diseases (e.g., syphilis, gonorrhea, chlamydia, HIV),
– Reduced blood flow to the anorectal area.

Anal fissures are also common in infants and women who have recently given birth.