Anal Fissure: When to See a Doctor

What is an anal fissure?

It is a longitudinal tear in the lining of the anal canal, most often caused by passage of hard stool. It can be acute (recent) or chronic (lasting beyond several weeks).

Typical symptoms

• Sharp, cutting pain during and after defecation
• Small amount of bright-red blood on toilet paper
• Spasm of the anal sphincter
• Occasional itching during healing

When to seek evaluation

• Symptoms persisting beyond 4–6 weeks despite conservative care
• Recurrent fissures
• Atypical location or appearance
• Associated systemic symptoms or weight loss

First-line management

Fibre, hydration, warm sitz baths and topical agents are the basis of treatment. Chronic fissures may require additional medical or surgical options determined after examination.