An anal fissure is a tear or an ulcer in the lining of the anal
Anal fissures can become chronic (permanent) where patients
experience some symptom-free phases (remissions) and worsening of
- Drink at least 8 glasses of water daily (as inadequate water
intake can encourage dry, hard stools to form).
- Eat high-fibre foods to promote regular bowel actions.
- Don't strain during defecation.
- Avoid anal intercourse
Anal fissures can occur when the walls of the anal canal are
stretched by large, hard stools or by a foreign object (e.g. during
The risks of developing an anal fissure are increased by certain
medical conditions, including constipation, multiple pregnancies,
leukaemia, Crohn's disease, immunodeficiency diseases (e.g. HIV)
and chronic use of laxatives.
- Pain and bleeding with bowel movements.
- The pain usually occurs with or shortly after defecation and
lasts for several hours before subsiding until the next bowel
- There may be streaks of blood on the toilet paper or
As with all medical conditions, consult your doctor for the
diagnosis and treatment of anal fissure. The diagnosis of anal
fissure is made by a physical examination and your doctor may need
to examine the lining of the anal canal using a special instrument
called an anoscope or sigmoidoscope
Anal fissures are fairly common and usually heal without
treatment or with nonsurgical treatments. Your Doctor may recommend
lifestyle and dietary changes e.g increasing fibre and water intake
etc. Your Doctor may recommend or prescribe a steroidal cream to
relieve inflammation and ease discomfort. An ointment containing
nitroglycerine may be prescribed for you. When applied to the anus
this helps to widen blood vessels and increase blood flow to the
tear, promoting healing.
- Most people recover in 4 - 6 weeks after receiving the
appropriate medical treatment. If the anal fissure does not heal,
surgery may be necessary to control the muscle spasms that prevent
the anal fissure from healing.
- Medications such as paracetamol can help relieve the painful
symptoms of anal fissure. DO NOT take a product that contains
aspirin or ibuprofen as these can prevent blood from clotting and
increase blood loss from the anal fissure. Aspirin should generally
not be given to children under 16 years of age unless specified by
a doctor. Aspirin should especially be avoided in children aged 12
to 15 if they are feverish.
Ask your Pharmacist for advice
1) Keep bowel movements regular. Ask your Pharmacist about some
fibre products (e.g. psyllium) and slippery elm to help.
2) Stool softeners can moisten the stools to minimise the risks of
aggravating the anal fissure during defecation. Ask your Pharmacist
to recommend a suitable product.
3) Drink plenty of water to prevent the stools from becoming dry
and hard. Consider using a water filter jug to provide clean,
filtered drinking water.
4) Warm compresses and baths can relieve the pain caused by anal
fissures. Ask your Pharmacist about a special sitz bath that
enables you to bath the buttock area without having to immerse the
rest of your body.
|Supplements And Herbs|
- Slippery elm and acidophilus feed the good bacteria in the
bowel, which helps aid in healthy bowel movements.
- Digestive enzymes (such as papain, bromelain, hydrochloric acid
tablets and pepsin) may increase digestion and elimination of
wastes. Digestive enzymes are available in formulas in health food
- Aloe vera juice is a laxative and decreases inflammation of the
- Magnesium may help cramps and griping associated with
constipation. Magnesium may help relax the bowel wall and promote
- Your diet should be high in fibre. Good sources of dietary
fibre include bran, wholemeal and wholegrain foods (e.g. brown
rice, wholemeal bread, oats); fresh, raw fruits and vegetables such
as apples and pears; and legumes (baked beans, 3-bean mix,
- Psyllium is a water-soluble fibre which may increase the bulk of
the bowel. Psyllium fibre should always be taken with a large glass
- For regulating bowel movements, apple cider vinegar taken daily
e.g. 2 teaspoonfuls in water on waking can be helpful. Linseed meal is a valuable source of fibre and is
also very tasty over cereal. Your health shop has a wide range of
wholegrain breakfast cereals to choose from.
- Minimise caffeine intake (cola, tea, coffee, chocolate) as it can
- Having a teaspoon of apple cider vinegar diluted in a glass of
water 30 minutes before main meals aids in the thorough digestion
of foods in the stomach by activating the secretion of hydrochloric
acid into the bowel.
- See the constipation diet topic on the Healthpoint for further
THIS IS NOT DIAGNOSTIC INFORMATION. STAY ON PRESCRIBED MEDICINES.
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