Anal fissure refers to a small tear or crack in the delicate lining of the anal canal. This condition causes severe pain and bleeding during or after bowel movements, making even simple activities uncomfortable. Although commonly linked to constipation and hard stools, anal fissures can also arise from other factors, such as persistent diarrhoea or underlying inflammatory conditions like Crohn’s disease.
When it is left untreated, anal fissures can disrupt daily life, affecting physical comfort, emotional well-being, and overall quality of life. Individuals may begin to fear bowel movements, leading to avoidance behaviours that further worsen constipation, and create a vicious cycle of pain and distress. Unlike minor skin tears that heal quickly, anal fissures, particularly chronic fissures, often require medical attention to relieve symptoms, promote healing, and prevent complications.
There are several types of anal fissures, which are typically classified based on their duration, and underlying cause. These include:
| TYPE OF ANAL FISSURE | DESCRIPTION |
| Acute Anal Fissure | Acute fissures are recent tears that develop suddenly, usually after a particularly hard or large bowel movement. These fissures often heal within six weeks with simple lifestyle changes, and conservative treatments, such as dietary adjustments, and topical medications. |
| Chronic Anal Fissure | Chronic fissures are persistent tears that fail to heal within six weeks. These fissures may have thickened edges or be associated with a sentinel pile, which is a small skin tag at the edge of the fissure. Chronic fissures often indicate ongoing muscle spasm in the anal sphincter, requiring more complex treatments such as Botulinum toxin (Botox) injections or surgery. |
| Primary Anal Fissure | A primary fissure occurs in the absence of any underlying medical condition. This is usually due to mechanical trauma, such as straining during bowel movements or passing hard stools. |
| Secondary Anal Fissure | A secondary fissure develops as a result of an underlying disease. These fissures may be linked to conditions such as Crohn’s disease, infections or anal cancer. Secondary fissures are often atypical in location, sometimes appearing along the sidewalls of the anal canal, rather than the common posterior midline. |
Anal fissures develop when the delicate lining of the anal canal tears, usually because of excessive strain or injury. Some of the most common causes include:
Some of the common symptoms of anal fissures are:
When anal fissures are improperly managed or left untreated, it can lead to several complications, such as:
| COMPLICATIONS | DESCRIPTION |
| Chronic Anal Fissure | Acute fissures that fail to heal within six weeks become chronic. These fissures develop thickened edges, and may be associated with a sentinel skin tag, a small growth that forms near the tear. |
| Emotional and Psychological Impact | Persistent pain, and bleeding from chronic fissures can significantly affect quality of life, leading to anxiety, embarrassment, or reluctance to seek medical care. |
| Infection and Abscess Formation | Fissures can occasionally become infected, especially if there is underlying inflammation or poor hygiene. This may lead to the development of an anal abscess, a painful collection of pus near the anus. |
| Persistent Anal Pain and Spasms | The anal sphincter muscle may go into continuous spasm in response to pain, further restricting blood flow to the area, and preventing healing. This vicious cycle often prolongs symptoms, and complicates treatment. |
Although anal fissures can affect anyone, some groups of people are more vulnerable due to their lifestyle, health status, and specific medical conditions. These risk factors include:
Diagnosing anal fissures at Alpine Surgical Practice involves a comprehensive assessment to confirm the diagnosis, and identify any contributing factors. A typical consultation may involve the following:
During the initial consultation, the following assessments are usually conducted:
Additional diagnostic tests may be recommended if necessary, such as:
When it comes to treating anal fissures, the choice of treatment depends on whether the fissure is acute or chronic, as well as the underlying causes. This may include:
Anal fissures can be a real pain—both figuratively and literally—but thankfully, they are also highly treatable, and early detection helps prevent more serious complications down the line.
Our compassionate, professional team is here to provide you with discreet, effective treatment tailored to your condition. If you are experiencing anal pain, bleeding or discomfort, contact us today (link to contact us page) for a detailed diagnosis and personalised treatment plan.
Anal fissures are relatively common in Singapore, affecting both adults, and children. Although they are not always discussed openly, they represent one of the most frequent causes of anal pain, and bleeding seen in clinical practice.
Anal fissures themselves are not life-threatening. However, they can cause significant discomfort, and impact daily life. In fact, chronic fissures may lead to infection or other complications.
Acute fissures can often heal on their own with appropriate self-care, such as increasing fibre intake, staying hydrated, and avoiding straining during bowel movements. However, chronic fissures are less likely to heal without medical intervention.
You can support healing by:
Yes, you can lower your risk by:
Unfortunately, recurrent fissures can occur, especially if the underlying cause is not well controlled. We will provide individualised advice to help prevent recurrence and maintain long-term anal health.
Anal fissures themselves do not cause cancer. They are benign tears in the anal lining caused by trauma or inflammation. However, in rare cases, fissures that fail to heal, despite appropriate treatment, may warrant further investigation to rule out anal cancer.
This is especially important if:
Mon–Fri | 9:00AM – 5:00PM
Saturday | 9:00AM - 12:30PM
Sunday & PH | CLOSED
Copyright © Alpine Surgical Practice | Terms & Conditions
