Anal Fissure Treatments
An anal fissure is a small tear or cut in the
skin lining the anus. Symptoms of an anal
fissure are extreme pain during bowel
movements and red blood streaking the
stool. Hard, dry bowel movements can cause
a tear in the anal lining causing a new
fissure (acute). Other causes include
diarrhea and inflammation of the area and
altered bowel habits. A fissure that is present
for a long time (chronic) may be the result
of poor bowel habits, tight anal muscles,
scars, or other medical problems.
An acute fissure (new onset) is treated
without surgery. With a change in bowel
habits, more than 9 out of 10 will heal.
These changes include eating a diet high in
fiber, drinking more water, stool softeners
and taking a bulk fiber such as Metamucil®.
This allows the passing of soft stool and
constipation is avoided. Warm baths for 10-
20 minutes several times a day are soothing
and promote relaxation of the anal muscles.
Special creams from your doctor may also
A chronic fissure (lasting more than a month
or one that heals and comes back) may
require surgery. A sphincterotomy is a
minor surgery to cut a portion of the internal
anal sphincter muscle. This helps the fissure
to heal by decreasing pain and spasm.
Cutting the muscle rarely causes problems
with the control of bowel movements.
Complete healing occurs in a few weeks,
pain is often better within a few days after
Day before Surgery
You may need to complete a bowel prep
before surgery to clear the intestines of
stool. This may include one of these:
ξ Drinking a clear liquid diet
ξ Drinking a laxative such as magnesium
The bowel prep will be tailored to your anal or
rectal problem and to your overall health.
Take a sitz bath at least 3-4 times a day and
after each bowel movement. A sitz bath is
sitting in a bathtub of warm water for 10-20
minutes. This will help decrease the pain of
muscle spasms and aid healing.
Your doctor may order pain pills. Follow
the directions from the pharmacist. You may
keep using the diltiazem cream as needed
for 1 month. After surgery you will take a
stool softener (docusate sodium) and a
bulk fiber laxative such as Metamucil® to
prevent constipation. You can buy these
without a prescription.
Eat a high fiber diet each day:
ξ 8-10 (8 oz) glasses of non-caffeinated
ξ At least 4 servings of fruits and
ξ At least 4 servings of whole grain bread
ξ Change your position from sitting to
standing to lying for comfort.
ξ You may return to work as soon as you
are comfortable and not taking pain pills.
ξ No driving while taking prescription
ξ Sex may be resumed when you are
ξ You will return to the clinic to see your
doctor, NP or PA in 1 – 3 weeks.
When to Call the Doctor
ξ Large amount of bright red blood that
does not stop with pressure to the area
for 10 minutes
ξ Fever over 100.4ºF for 2 readings, 4
hours apart. Take your temperature once
a day for a week.
ξ Foul-smelling drainage
ξ Excess swelling
ξ You cannot control bowel movements
ξ Trouble passing urine
Digestive Health Center: 608-890-5000
After hours, weekends or holidays ask for
the doctor on call. Leave your name and
phone number with area code. We will call
Toll Free: 855-342-9900
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 11/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5467