Anal Fissure

An anal fissure is a small tear or cut in the skin around your bottom (anus). Think of it like a tiny paper cut in a very sensitive area. It can be quite painful, especially when you go to the toilet.

What Does It Feel Like?

If you have an anal fissure, you might notice:

• Sharp, severe pain when you poo - many people describe this as feeling like passing glass
• Burning pain that continues for hours after you've been to the toilet
• Bright red blood on the toilet paper or in the toilet bowl
• Fear of going to the toilet because of the pain

The pain happens because the area around your bottom has lots of nerve endings, making even a small tear very uncomfortable.

What Causes Anal Fissures?

Anal fissures often happen when:

• You're constipated and strain to pass hard, dry poo
• You have diarrhoea frequently
• You're pregnant or have recently given birth
• You have a long-term bowel condition like Crohn's disease

They're most common in people aged 15 to 40, and in young children. Sometimes there's no clear reason why they happen.

How Can You Help Yourself?

The good news is that most anal fissures heal on their own. Here's what you can do to help:

Do:

• Take paracetamol or ibuprofen for pain relief
• Drink plenty of water (aim for 6-8 glasses a day)
• Eat foods high in fibre like fruits, vegetables, and wholemeal bread to keep your poo soft
• Have a warm, shallow bath after going to the toilet - this can really help with pain
• Keep your bottom area clean and dry
• Go to the toilet as soon as you feel the urge - don't wait

Don't:

• Ignore the need to go to the toilet, as this can make constipation worse
• Strain when going to the toilet
• Use rough toilet paper - try softer varieties or wet wipes

When Should You See Your GP?

Speak to your GP if:

• Your symptoms are getting worse
• There's no improvement after a week of self-care
• You're worried about your symptoms
• Your child has these symptoms

See your GP urgently if you have:

• Lots of bleeding from your bottom
• Severe pain that isn't helped by painkillers
• Signs of infection like fever or feeling unwell

What Can Your GP Do?

Your GP will ask about your symptoms and may need to examine your bottom area. This might feel embarrassing, but remember that GPs see this type of problem often and want to help you feel better.

If self-care isn't working, your GP might suggest:

• Medicines to help soften your poo
• Creams to help the tear heal faster
• Medicines to reduce muscle spasms around your bottom

In rare cases where the fissure won't heal, you might need a small procedure done in hospital while you're asleep.

Remember

Most anal fissures heal completely with simple self-care measures. The key is keeping your poo soft and managing any pain while your body heals naturally. If you're concerned about any symptoms, don't hesitate to speak to your GP - they're there to help.

---

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.