What are anal fissures?
An anal fissure is a tear in the lining of the anal canal (back passage) which causes pain and bleeding on opening the bowels.
Anal fissures are common. They usually occur in people aged 15–40 years or in young children.
What causes anal fissures?
Most anal fissures are thought to be due to passing large or hard stools when you are constipated.
Other causes include:
- Diarrhoea
- Childbirth
- Bowel conditions such as Crohn’s disease or ulcerative colitis
- Sexually transmitted infections
What are the common symptoms of anal fissures?
- sharp pain/ itching when you open your bowels
- burning pain after you open your bowels that may last for several hours
- bright red blood in the toilet or on the toilet paper after you open your bowels
How are anal fissures diagnosed?
Always speak to a GP if you have bleeding from the back passage as this can indicate a serious diagnosis such as bowel cancer
Diagnosis is usually based on symptoms and rectal examination.
During an online GP consultation, we can:
- Assess symptoms and risk factors
- Provide treatment advice or prescriptions if needed
NB. You may need in-person assessment if the diagnosis is unclear and a physical examination is required.
When to Seek Urgent Medical Help
Go to A&E or seek urgent help if you have:
- severe worsening pain
- fever/chills
- heavy bleeding
- dizziness
- discharge from the anus
- inability to move
- if you suspect a foreign object is stuck in the rectum
What are treatment and management options for anal fissures?
Self-Care and Home Management
Most anal fissures heal by themselves within six to eight weeks.
You can aid the healing process with the following:
- Keep the stools soft with a high fibre diet, plenty of water and physical activity.
- Paracetamol for pain relief (avoid codeine). Sitting in a warm bath may also help.
- Keep the area clean and dry to prevent infection.
- Consider taking an over-the-counter laxative.
- Ask the pharmacist for some ointment to help numb the area.
Treatment from a GP
A GP can help with:
- Confirming the diagnosis.
- Advice on when symptoms may indicate complications.
- Recommendation for further treatment.
When referral is needed
You may need further assessment by a colorectal surgeon if symptoms persist or symptoms worsen despite initial care.
How Dr.Online UK can help
We offer:
- Same-day online GP appointments
- Expert assessment and guidance
- Private prescriptions (when appropriate)
- Fit notes or referral letters
- Clear advice on whether you need in-person care
