An anal fissure occurs when there is a cut, scratch or tear in the thin lining of the anus region. A deep tear may even extend up to the muscle around the anus called the anal sphincter. These tears are common, often associated with pain, bleeding and a sharp burning sensation, often confused with the symptoms of haemorrhoids. These tears or cuts cause muscle spasms, which can further pull apart the edges of the anal fissure, causing pain and slowing down the healing process altogether. Frequent hard bowel movements can also keep the fissures from getting better.

An anal fissure is at its acute stage if you have recently had it or it has happened for less than 6 weeks. If you have been suffering from anal fissures for more than 6 weeks or it has been reappearing, then it is chronic. Men, women and even babies can have anal fissures, however, adults between 20 and 40 are most likely to get them. People can always be at risk of getting anal fissures, although the risk goes down with age. People with symptoms of anal fissures must first get it diagnosed by a medical practitioner before going for any remedies.

What are the causes of Fissure?

Any kind of trauma, abrasion and tear in the anus and anal canal may cause anal fissures. This injury can be caused for the following reasons:

• Insertion of foreign objects into the anus
• Prolonged diarrhoea
• Anal sex, anal stretching
• Chronic constipation
• Straining to have a bowel movement, especially if the stool is large and hard

Causes other than trauma can be:

• Extremely tight anal sphincter muscles 
• Poor bowel habits
• Scarring in the anorectal area

Anal fissures aren’t usually serious and should gradually heal within 2-3 weeks. If they persist or recur very frequently and are associated with scarring and severe pain, a person should consider getting them physically examined by a physician.

Dr Ashish Bajaj – M.B.B.S, M.D. in Clinical Pharmacology and Toxicology

Types of Fissure

Based on the causes, anal fissures can be classified into types. In acute cases, an anal fissure condition may effectively improve within 6 to 8 weeks of medical therapy. Studies have found that for chronic or non-healing fissures lasting more than 10 weeks, surgery is much more effective than any other treatment option.

• Primary Fissures: Caused due to injury to the local tissues, these types of fissures are short-lived and practically non-threatening. The injury may be related to some injury, trauma, passing hard stools, chronic diarrhoea of the patient, childbirth by vaginal delivery or even anal intercourse.
• Secondary Fissures: Such fissures often occur in patients with prior surgeries in the anus, patients with inflammatory bowel disease, infections and even cancer. These fissures may require surgical removal and are long-lived and much more serious. 

Symptoms of Fissure

Fissures are painful and cause discomfort when you are sitting or even standing. Fortunately, there are symptoms and signs that you can watch out for to get diagnosed sooner:

• Pain: The most common and highly reported symptom of anal fissure is pain, as experienced by patients as severe, burning and tearing in nature. This pain heightens usually during the passing of stools. This pain may also last for minutes to hours after stool passage.
• Bleeding: This has been described as bright red spots of blood on the toilet paper, toilet bowl or blood streaks on stools. Blood may also form in drips while stool passes. 

Home remedies for fissures

Your doctor may suggest some simple diet and lifestyle changes and other remedies along with the required treatment to deal with the pain and discomfort due to fissures. Here are some other home remedies that you can easily find at home to comfort yourself if you are suffering from anal fissures:

1. Include papaya in your diet

 Papayas are imbued with enzymes that may help improve digestion. Studies have shown that Caracol, a supplement made with papaya extracts, has effectively lowered the chances of constipation and bloating among people with gastrointestinal dysfunction and digestive disorders. Papayas are extremely hydrating, as they comprise 85% water. Getting enough water in the body’s system can lower the chances of dry stools, often associated with dehydration.

2. Drink lemon water

 Lemons are loaded with vitamin C. The juice from 1 medium-sized lemon has 21% of the Daily Value of vitamin C required by an adult. Vitamin C plays an essential role in working as an antioxidant. As vitamin C is water-soluble, it is not stored in the body. Hence, vitamin C can aid in smooth bowel movements. It is not recommended to take large doses of vitamin C, but according to research, a daily constant dose of vitamin C may be effective in passing the bowel smoothly.

3. Use the benefits of turmeric

Turmeric has ñ medicinal properties that have been recognised for centuries, due to the presence of an active ingredient called curcumin in it. Turmeric is also known for its anti-inflammatory and antioxidant properties. Turmeric may aid in soothing the pain and provide relief in the target area. However, more research is being done on the use of topical turmeric treatments for anal fissures.

4. Have oatmeal in breakfast

 Oatmeal is loaded with soluble fibre, which helps your stools retain water. This may effectively target dry stools, a common cause of fissures. Ultimately, eating more oatmeal and other food items that have soluble fibre keeps stools soft, making them easier to pass.

5. Eat one banana daily 

Bananas are a great source of fibre, which may help relieve constipation. A study found that 77% of people with constipation experienced increased stool frequency and softer stool consistency after increasing their fibre intake. Since bananas are loaded with fibre, consuming them will help in passing softer stools.

6. Consume ghee as a part of your diet 

Ghee has traditionally been used in Indian households for centuries. Ghee contains butyrate acid, a type of fatty acid that may effectively promote digestion and it is used in moderation to lower the chances of gastrointestinal disorders like diarrhoea and irritable bowel syndrome. Reports also support the use of ghee as a natural laxative. Ayurvedic health practitioners recommend taking 1 teaspoon of ghee in milk or water to promote smooth bowel movements.

7. Healthy and clean diet

 The patients suffering from anal fissure are suggested to intake more fluids by drinking a lot of water and consuming a fibre-rich diet for easy passage of stool. Avoiding junk food, food with zero fibre content or no water content should be avoided when the patient is experiencing symptoms of anal fissures.

8. Sitz bath

A warm sitz bath may relieve you from pain and discomfort due to anal fissures. The simplest Indian home remedy for anal fissures is to fill warm water in a bathtub and add a few drops of betadine liquid by mixing it thoroughly. Sit in a straight posture in the tub for about 10-20 minutes. You can repeat it three times each day to get relief from the pain and discomfort associated with anal fissures.

Sitz bath is a warm, shallow bath you sit in to relieve discomfort in your perineal region. Soaking this area in warm water relaxes your anal sphincter, which helps increase blood flow through your anal tissues. This promotes healing and reduces the pain, itching and irritation felt due to various health conditions.

Dr. M.G. Kartheeka – MBBS, MD(Pediatrics)

Also Read: How to Stop Itchy Anus at Night: Effective, Research-Backed Solutions

When to seek professional help?

You should seek a doctor’s help without delay if you experience the symptoms like a fissure. These symptoms mimic other conditions like piles, fistula or even cancer. Follow up with your doctor if you:

• Still have symptoms after 7-18 days of initial treatment
• Have bleeding from your rectum
• Have unbearable pain and an extreme problem with stool passing.

Thus, symptoms of anal fissures to some extent may be comforted by simply following these home remedies. But in most cases, the home remedies for anal fissures can only give temporary relief to the patient. It is important to consult a doctor and follow the suggested treatment right from the day of onset of symptoms. 

Frequently Asked Questions (FAQs):

Disclaimer: The information included on this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation