The main causes of anal fissures

Written by Deng Heng
Colorectal Surgery
Updated on March 06, 2025
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The main causes of anal fissure formation may be related to the following factors: long-term constipation and hard stools, which cause mechanical damage during defecation as the direct cause for most anal fissures. It is also related to anatomical defects. Due to the superficial layer of the external sphincter forming a weak area at the back of the anal canal, dry stools exert the greatest pressure on the weak area at the back of the anus, making it prone to tearing injuries. Additionally, infection of the anal sinuses can lead to inflammation of the anal canal, and spasms of the sphincter losing its soft characteristics is also a reason for the formation of anal fissures. Furthermore, hard and dry fecal masses passing through the anal canal can easily cause tearing injuries, possibly due to the smaller size of the patient's anus.

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Written by Du Rui Xia
Obstetrics
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How to treat postpartum constipation and anal fissures?

In cases of postpartum constipation, if it becomes severe and leads to an anal fissure, it is necessary to visit the hospital's proctology department for an examination. When an anal fissure occurs, it generally requires the use of medications to invigorate blood and dissolve stasis to facilitate wound healing. You can also apply some grease around the wound to increase the lubrication of the muscles around the anus, which can alleviate some of the difficulties experienced during defecation. In daily life, it is important to drink more water, consume plenty of fresh vegetables and fruits, avoid spicy and irritating foods that can cause internal heat, and you can also use a potassium permanganate solution for sitz baths to alleviate local pain. If the condition of the anal fissure is severe, surgical treatment may be necessary.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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What should be paid attention to usually for anal fissures?

What should I pay attention to for anal fissures? Friends who suffer from anal fissures should note the following: Firstly, pay attention to your diet. Adjust your diet structurally to be diverse. Drink plenty of water and eat less spicy and stimulating food; abstain from alcohol and betel nuts; eat less spicy hot pot and similar foods. Also, maintain a smooth bowel movement. We should develop a habit of defecating regularly, and treat constipation correctly. However, in treating constipation, we should not misuse laxatives and should use medications under the proper guidance of a doctor. We should also pay attention to keeping the anal area clean and hygienic by washing it after each bowel movement. After defecation, it is best to perform sitz baths using salt water, traditional Chinese medicine pain relievers like Shen Tang, or potassium permanganate solution. This helps in the recovery of the anal fissure. In addition to the above, we should also engage in appropriate activities. Friends with anal fissures can perform anal muscle contractions, such as Kegel exercises or stretching exercises.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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symptoms of anal fissure

What are the symptoms of an anal fissure? The most typical symptoms of an anal fissure are clinically manifested in three aspects: pain, rectal bleeding, and constipation. Firstly, constipation: Many patients with anal fissures generally first exhibit symptoms of constipation. Then, due to the dryness and bulkiness of the stool, the skin around the anus tears, forming an anal fissure. Subsequently, because of anal pain, the patient fears defecation, which over time exacerbates the hardness of the stool. As constipation worsens, it can aggravate the fissure, thereby creating a vicious cycle. The second main symptom is pain, which is not only the most significant symptom of an anal fissure but also potentially the most intensely felt by the patient. The skin around the anus is sensitive, and damage to this skin can cause significant pain. The degree and duration of the pain can also indicate the severity of the fissure. Typically, the pain from an anal fissure is cyclical. It usually occurs during defecation, followed by a few minutes of relief. Then, pain is stimulated by the contraction of the internal anal sphincter, causing sustained spasms of the sphincter, leading to severe pain. This pain can last for several minutes or even hours. During this time, the patient may feel extremely uncomfortable and find it unbearable, some only finding relief when the sphincter muscles relax after fatigue. Then, the pain reoccurs with the next bowel movement, characterized by its cyclic nature. The third main symptom is rectal bleeding. Patients may notice droplets of blood during defecation, sometimes spotting a few drops of bright red blood in the toilet bowl or seeing streaks of blood on the stool, occasionally mixed with intestinal mucus. When wiping the anus, sometimes the toilet paper shows red blood. However, the amount of bleeding is related to the size and depth of the fissure—the larger and deeper the fissure, the more bleeding occurs. Additionally, some patients may experience itching around the anus. The ulcerated surface of the fissure, along with secretions from the anal glands, irritates the skin around the anus, which can lead to perianal eczema and itching.

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Written by Chen Tian Jing
Colorectal Surgery
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What should be paid attention to for anal fissures usually?

Patients with anal fissures primarily develop the condition due to a history of dry stools or straining during early bowel movements. Therefore, it is important for patients to ensure smooth bowel movements and avoid excessive dryness of stools. Diet adjustments should include consuming more bland vegetables and fruits, and avoiding spicy foods such as chili peppers, seafood, and mutton, which are irritants. Additionally, ensuring adequate daily water intake is crucial to prevent dryness in the intestinal feces. Besides dietary and bowel adjustments, patients with anal fissures should actively seek medical treatment during acute episodes to prevent the recurrence of early fissures and the formation of chronic fissures. Early-stage fissures may be treated with topical medications to alleviate symptoms, while chronic fissures may require surgical intervention. (Medication should be administered under the guidance of a doctor.)

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Written by Deng Heng
Colorectal Surgery
55sec home-news-image

The main causes of anal fissures

The main causes of anal fissure formation may be related to the following factors: long-term constipation and hard stools, which cause mechanical damage during defecation as the direct cause for most anal fissures. It is also related to anatomical defects. Due to the superficial layer of the external sphincter forming a weak area at the back of the anal canal, dry stools exert the greatest pressure on the weak area at the back of the anus, making it prone to tearing injuries. Additionally, infection of the anal sinuses can lead to inflammation of the anal canal, and spasms of the sphincter losing its soft characteristics is also a reason for the formation of anal fissures. Furthermore, hard and dry fecal masses passing through the anal canal can easily cause tearing injuries, possibly due to the smaller size of the patient's anus.