Anal fissure

​An anal fissure refers to a tear or an ulcer (open sore) in the lining of your anal canal, causing pain during your bowel movements. This canal constitutes the last part of your large intestine, and is located between your rectum (which stores stool) and the opening in your bottom where you pass stools. Injury may be caused by passing a hard stool, or repeated diarrhoea. Anyone can get an anal fissure, even young and otherwise healthy people.

Mostly anal fissures heal within a few days or weeks with non-operative treatments that can be taken with comfort at your home. However, if you have an anal fissure that has not healed within eight to twelve weeks (a chronic fissure) and has persistent symptoms, it may require surgery.

The <GI and Surgery Service Line> at The Aga Khan University Hospital, is well equipped to treat anal fissures and is highly trained in performing surgical treatments that are in line with international standards. 

  • Sharp, stinging or burning pain – you may experience sharp pain or stinging when you pass stool and a burning sensation after that may be brief or else may persist for several hours.

  • Bleeding – you may notice bleeding or a small amount of bright red blood when you pass stool. Your stool may be streaked with blood. 

  • Itching – an anal fissure may cause itchiness around the anal passage.​​

​You should seek the advice of your doctor if you notice any symptoms that can be associated with an anal fissure or that are causing you discomfort.  Some people are hesitant to seek help about an anal fissure or symptoms because they are embarrassed or shy. There is no reason to be embarrassed as doctors are used to seeing cases of anal fissures. The doctors at the Aga Khan University Hospital will do their best to make the process as comfortable for you as possible. They will be able to give you expert treatment and advice to help alleviate your symptoms and reduce the chances of a recurrent fissure. 
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

When you visit your doctor with symptoms of an anal fissure, they will begin by asking you details about the symptoms or pain that you are experiencing. They may also ask you about your bowel and toilet habits. 

Your doctor will then perform a physical examination and inspect your bottom to see if there are visible indicators of an anal fissure. This is nothing to be embarrassed about, and is quite essential for a proper diagnosis. In a few cases, you may need to undergo further examination and tests in order to make an accurate diagnosis or to rule out other possible underlying causes, such as inflammatory bowel disease for instance. ​

Anal fissures usually heal within a few weeks and do not require medical treatment. However, they may recur easily if it was caused by constipation which remains untreated. However, in other cases the symptoms may persist for six weeks or more, in which case they are referred to as a chronic anal fissure. These will probably require medical treatment in order to heal.

Non-surgical medical treatments options to treat an anal fissure include medications prescribed by your doctor.

Surgical procedure for anal fissure:

A surgery may be recommendable in cases of a severe pain due to anal fissure, or when the symptoms of an anal fissure are persistent and do not heal with other forms of treatment. The surgery to correct an anal fissure is called a lateral internal sphincterotomy.

During the procedure, a thin portion of muscle for your anal sphincter is divided in order to help your wound heal faster.  ​

​Please click here for some guidelines on “what to do before your surgery”
Please click here for some guidelines on “what to do on the day of your surgery”​

The surgery to treat an anal fissure is usually very effective. However there is a small risk of complications which may include:

  • Faecal incontinence – this is mostly  temporary 

  • Excessive bleeding 

  • Inability to urinate 

  • Infection 

  • Problems associated with anaesthesia – such as a negative reaction to medication or difficulty in breathing

  • Chances of developing an abscess or fistula 

Please click here for some guidelines on “what to do on after your surgery”​

The Aga Khan University Hospital offers various support services to help ​with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

​The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​​