Fissures are cracks or tears in the skin and occur when the skin separates and pulls apart. If left untreated, it can develop into ulcers [a large open wound]. In severe cases, they can affect underlying muscles and bone tissues. One of the most common types of fissure is an anal fissure. Anal fissures are tears in the lining of the anus that causes severe pain during bowel movements.
Anal fissures are of two types: acute anal fissures and chronic anal fissures. Acute anal fissures are also called short-term anal fissures as they can heal within a few days or weeks. Chronic anal fissures are regarded as long-term anal fissures as they won’t heal even after eight  to twelve  weeks. An acute anal fissure can be treated with medications, dietary changes, and lifestyle modifications, whereas chronic anal fissures may require surgical intervention with medication therapy.
An anal fissure can be caused by several reasons and a few of the most common reasons among them are listed below.
- Passing large or hard stools
- Prolonged constipation
- Straining during bowel movements
- Poor cleaning habits
- Pregnancy and vaginal childbirth
- Chronic diarrhea
- Anal intercourse or anal sex
- Tight sphincter muscles around the anus
- Anorectal cancer
- Crohn’s disease or another inflammatory bowel disease
- Sexually transmitted diseases like HIV, Syphilis, and Herpes
In a few cases, anal fissures can be idiopathic where the exact reason or cause is unknown. If you are suffering from an anal fissure, contact your doctor to get diagnosed and treated. In any case, if the anal fissure is left untreated, it can affect the underneath muscles and bones.
A few major and common symptoms of anal fissures are listed below.
- During bowel movements, you can suffer from severe and sharp pain in the anal region.
- You can notice bright red blood on the stool or toilet paper after your bowel movement.
- Presence of a visible crack or tear in the skin around your anus.
- Near the anal fissure, you can find a lump or skin tag.
- Burning or itching sensation in and around the anal region
If you are suffering from an anal fissure, you can notice any of the above-mentioned symptoms. Based on the severity of anal fissure and the symptoms, your doctor can recommend either medication therapy, lifestyle modification, dietary changes, or surgery.
Multiple risk factors can increase the chances of development of anal fissure, and a few of them are:
- Constipation: Straining during bowel movements and passing hard stools can increase your risk of developing an anal fissure or tear or crack in the anus.
- Childbirth: The occurrence of anal fissures is more common in women after they give birth as it can increase and put pressure in the anal region and lead to cause a tear or crack in the anus.
- Inflammatory bowel diseases: Inflammatory bowel diseases like Chron’s disease and ulcerative colitis can cause chronic inflammation of the intestinal tract, which can make the lining of the anal canal more vulnerable to tearing.
- Anal intercourse: In rare cases, having anal sex can overstretch the skin of the anus and causes anal fissures.
- Age: Anal fissures are more common in infants and middle-aged adults. However, individuals at any age can get affected by an anal fissure.
If anal fissures are left untreated they can become serious and can cause complications such as:
- Failure to heal: If anal fissures are not healed within four  weeks they can become chronic and fail to heal on their own. In such cases, surgery is the only best and safest option.
- Recurrence: If you have an anal fissure and left untreated, then you are at a higher risk of developing more cracks or tears in your anus.
- Anal stenosis: Due to the spasm of the anal sphincter or contraction of the scar tissue, the anal canal can become abnormally narrowed and lead to anal stenosis.
- Extension of crack or tear: In a few cases, an untreated anal fissure can extend into the internal anal sphincter muscle that holds your anus closed. In such cases, it is difficult to heal the fissure and can cause severe pain and discomfort that would require medication therapy along with surgical intervention.
Anal fissures can develop at any age and can cause sharp & severe pain in the anal region. Constipation, pregnancy, poor cleaning habits, and straining during bowel movements are major risks factors to develop an anal fissure. If you are suffering from an anal fissure, based on your overall health condition and severity of the anal fissure, your doctor may recommend either lifestyle modifications with dietary changes or anal fissure surgery.