Bowel movements are a fact of life. But the severe pain caused by anal fissures doesn’t have to be. Thankfully, there are steps you can take to find relief and help yourself heal.
First, what are anal fissures? They’re tiny rips or cracks in the anal canal. They have many causes, among them constipation, large bowel movements, childbirth, repeated diarrhea and conditions that reduce blood flow to the anus. In some cases, the fissures could be a sign of another condition, such as Crohn’s disease, according to the Mayo Clinic. (Think you might have irritable bowel syndrome? Here’s what to look for.)
Anal fissures can be incredibly painful. Many people report that they make hemorrhoids — inflamed blood vessels in or around the anus — seem painless by comparison.
“Nobody has ever died of a fissure, but it can be one of the more painful rectal conditions to experience,” says Mark Bazalgette, MD, a proctologist in Novato, California, who has specialized in anal fissures for nearly 30 years. “Fissures can bring grown men to their knees, and the pain can last for hours [after a bowel movement].”
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Do anal fissures heal on their own?
In some cases, yes, says Dr. Bazalgette. But not always.
There are 2 kinds of fissures: acute and chronic. Acute fissures are the ones that may heal on their own, while chronic ones generally do not. A fissure is considered chronic if it lasts for more than 8 weeks.
As Dr. Bazalgette explains, fissures cause “broken glass” pain because they are open wounds in a sensitive area. This pain triggers a spasm reflex, which in turn amplifies the pain and stops blood from reaching the injury. Without blood, the natural healing process is delayed. And the suffering is unlikely to end without intervention.
“The cycle continues until you fix the underlying problem,” says Dr. Bazalgette. “Without doing that, anyone who has had an anal fissure once is more likely to get one again.”
How do you find relief from fissures?
One of the first steps is to stay ahead of constipation. To soften bowel movements, make sure you’re eating enough fiber. Good sources include fruits, vegetables, legumes and whole grains. Fiber supplements can help too. And you should drink plenty of water.
In addition to improving your diet, it’s also important to exercise every day. The activity can help keep your digestive tract moving, says Dr. Bazalgette.
In some cases, health care providers have their patients take stool softeners or periodic laxatives. (Download a coupon for the laxative Lactulose®.) And for years doctors have recommended sitz baths, which fit inside your toilet to wash your underside.
The usual recommendation for a sitz bath is 15 minutes. Doing this twice a day can alleviate pain and improve healing, according to researchers at Creighton University in Omaha, Nebraska.
It’s also important to honor the urge to use the bathroom. Holding in a bowel movement will ultimately make any constipation and pain worse, according to Alberta Health Services. For added relief, consider wiping with baby wipes or medicated pads, says the organization. (Learn more about coping with constipation here.)
