Anal Fissure: Care Instructions

Overview

An anal fissure is a tear in the lining of the lower rectum (anus). It can itch and cause pain. You may notice bright red blood on toilet paper after you wipe. A fissure may form if you're constipated and try to pass a large, hard stool or if you don't relax your anal muscles during a bowel movement.

Most anal fissures heal with home treatment after a few days or weeks. If you have an anal fissure that takes more time to heal, your doctor may prescribe medicine. In rare cases, surgery may be needed.

Anal fissures don't lead to colon cancer or other serious illnesses. But if you have blood mixed in with the stool, talk to your doctor.

How can you care for yourself at home?

• If your doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
• Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water.
• Avoid constipation:
  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fiber.
  • Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
  • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
  • Take a fiber supplement, such as Benefiber or Metamucil, every day if needed. Read and follow all instructions on the label.
  • Use the toilet when you feel the urge. Or when you can, schedule time each day for a bowel movement. A daily routine may help. Take your time and do not strain when having a bowel movement. But do not sit on the toilet for more than 10 minutes.
• Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position.
• Your doctor may recommend an over-the-counter laxative, such as Miralax, Milk of Magnesia, or Ex-Lax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis.
• Do not use over-the-counter ointments or creams without talking to your doctor. Some of these preparations may not help.
• Use baby wipes or medicated pads, such as Preparation H or Tucks, instead of toilet paper to clean after a bowel movement. These products do not irritate the anus.
• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.