In short
An anal fissure is a tear in the lining of the anal canal, often following hard stools or diarrhoea. Pain can trigger spasm of the sphincter muscle, reducing blood flow and preventing healing.
Seek prompt care for fever, rapidly increasing pain, swelling or pus, which may indicate infection or an abscess.
What happens at the examination
The symptom pattern is often typical. Examination is adapted to your pain and performed gently. An unusual position or appearance may require further investigation.
- Gentle inspection
- Assessment of acute or chronic fissure
- Review of bowel habits
- Plan for medical or surgical treatment
Treatment options
The most suitable treatment is decided after an individual medical assessment.
After treatment
Treatment often takes several weeks. Follow advice on stools and medication carefully and return if pain or bleeding does not improve.
Frequently asked questions
Is a fissure the same as haemorrhoids?
No. A fissure is a tear in the lining, whereas haemorrhoids are enlarged vascular cushions.
Why does the pain continue after a bowel movement?
The tear can trigger spasm in the sphincter muscle. This reduces blood flow and may make the pain continue after passing stool.
How long does healing take?
A recent fissure may heal within weeks, while a chronic fissure often requires longer treatment.
What can I do myself?
Keep stools soft, avoid straining and follow the prescribed topical treatment. Adequate fluid and fibre may help, but advice is individual.
Can a fissure become chronic?
Yes. Ongoing pain and muscle spasm can prevent healing, and a small skin tag may develop with long-standing symptoms.
Is proctoscopy required when the pain is severe?
The examination is adapted to your pain. A gentle inspection is often sufficient initially, with further examination performed when possible and medically indicated.
Is surgery always needed?
No. Most fissures are first treated with stool regulation and medication.
Can a fissure return?
Yes. New constipation, hard stools or diarrhoea can increase the risk, so preventive bowel habits remain important after healing.
Medically reviewed by Dr Elias Tsiolis, specialist in general surgery, senior consultantUpdated 2026-10-25This text does not replace an individual assessment.