The anal canal is the end part of the intestinal tract. It includes the rectum and anus. Stool is passed through the anus. Sometimes a crack or tear occurs in the lining of the anal canal. This condition is called an anal fissure.
Anal fissures are caused by injury or stretching of the anal canal. This is most often due to having hard, difficult-to-pass stools (constipation). Severe diarrhea or placing an object into the anal canal may also cause a fissure.
Symptoms include pain and bleeding, especially during a bowel movement. Sometimes there is swelling, itching, and skin irritation. The area may spasm, causing more pain and skin separation. The most common complication is infection, which may lead to a pocket of pus (an abscess). When this happens, there may also be discharge from the fissure.
An anal fissure often heals on its own with no special treatment. Home care instructions to help prevent constipation and ease symptoms may be given. Once the area has healed, follow-up tests may be needed.
In some cases, a fissure does not heal on its own. Surgery may then be needed to close the tear.
Your child may be prescribed medicines, such as pain relievers, stool softeners, or laxatives. Follow all the instructions when giving any of these medicines to your child. Don't give your child over-the-counter medicines without talking with the healthcare provider first.
To help ease constipation, you may be told to:
Add more fiber in your child’s diet. This includes foods such as whole grains, fresh fruits, and vegetables. Fiber adds bulk to stool and absorbs water to soften stool. This helps stool pass through the colon more easily. If needed, a fiber supplement may also be prescribed.
Encourage your child to drink lots of water. This can also help soften stool.
To help ease pain and relax the muscles in the anus, have your child soak in a bath with a few inches of warm water. This is a called a sitz bath. Your child should do this for 10 to 15 minutes at a time, a few times a day, or as advised.
Keep a careful record of when your child has a bowel movement and the type of stool that was passed. This may help the healthcare provider figure out future care for your child. Older children should be encouraged to keep their own record.
Check your child’s anus for bleeding or signs of infection. Older children may be asked to watch their own symptoms.
Follow up with your child’s healthcare provider, or as advised. If testing was done, you’ll be told the results and any new findings that may affect your child’s care.
Unless your child’s healthcare provider advises otherwise, call the provider right away if:
Your child's symptoms get worse, or they don’t get better with home care measures.
Your child has signs of infection such as increased redness, swelling, or foul-smelling drainage in the area around the fissure.
Your child has ongoing constipation or explosive diarrhea.
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