When dealing with the pain and burning associated with them, the only question on your mind may be: “How do you Know if a Fissure is Healing?” Anal fissures, which may be chronic (recurring) or acute (sudden and short-lived), are tears, cracks or ulcers that develop in the anus or anal canal.

Trauma is the primary cause of these tears. However, there are a number of non-traumatic diseases linked to anal fissures that should be suspected if the fissures are located in unusual parts of the body. Doctors diagnose and evaluate anal fissures by visually inspecting the anus and anal canal. The gold standard for treating this condition is a surgical procedure known as lateral sphincterotomy. However, due to complications, the procedure is reserved for patients who have not been cured with non-surgical treatments or who have an intolerance for non-surgical treatments. Read on for more information on what is an anal fissure, how do you know if a fissure is healing, and what can you do to treat a fissure at home.

I. What is an Anal Fissure?

An anal fissure is a tear or a cut that occurs in the anus and extends upwards into the anal canal. It happens in the anoderm, a specialized tissue lining the anus and anal canal. This is a common condition when it comes to this part of the body and is responsible for a significant number of visits to colorectal surgeons.

Fissures are extremely common in young infants but also affect both men and women as well as the young and the old. In most cases, fissures cause severe pain during bowel movements.

In most cases, anal fissures are not a serious condition. 60% of anal cracks or tears heal on their own within 4 to 6 weeks. If the condition persists for more than eight weeks, it is considered long-term or chronic.

There are certain treatments that can heal the fissures and relieve the pain and discomfort that comes with them, such as topical pain relievers and stool softeners. If these treatments do not help in improving an anal fissure, it may be necessary to undergo surgery. Or your doctor may need to check if there is any underlying disorder that could be causing the fissure.

A. What causes anal fissures?

Some of the common causes of anal fissures include the following:

  • Passing hard or large stools
  • Chronic diarrhea
  • Constipation and straining during bowel movements
  • Spastic or overly tight anal sphincter muscles
  • Reduced flow of blood to the anorectal area
  • Straining during childbirth
  • Inflamed anorectal area brought on by Crohn’s diseases or any other inflammatory bowel disease (IBD)

Causes of anal fissures that are less common include:

  • Anal cancer
  • Tuberculosis
  • Herpes
  • Syphilis
  • HIV

B. Symptoms of anal fissures

Signs and symptoms of anal fissures include the following:

  • Pain during bowel movements, which can sometimes be very severe
  • Pain after bowel movements, which can sometimes last up to a number of hours
  • Irritation or itching around the anus
  • Bright red blood on the stool or toilet paper after bowel movements
  • A crack that is visible in the skin around the anus
  • A skin tag or a small lump on the skin near the anal fissure

To learn more about anal fissure symptoms, and causes, check out this video by YouAsk MD Answers:

II. How do you know if a fissure is healing- Treatment options for Anal Fissures

When it comes to treatment for anal fissures, the goal is to break the cycle of spasm of the anal sphincter and the repeated tearing it causes to the anoderm. In most cases, this condition does not require extensive treatment.

As mentioned earlier, OTC stool softeners and topical ointments are often prescribed to treat the fissures and reduce inflammation, irritation, and discomfort and increase blood flow to the anorectal area.

Treatment for Curing Anal Fissures Permanently

The first step to treating fissures is eliminating the pain. The second is to treat symptoms like diarrhea, hard stool or constipation, while the third step is to cure water retention, acidity, or other gastric disorders. The fourth step is to make lifestyle changes to prevent fissures from recurring. This is the general process to eliminate fissures and almost any type of other anal diseases.

In case you are suffering from chronic anal fissures, it may be necessary for you to undergo surgery first. After the procedure, you can go ahead and follow the four stages of treating anal fissures accordingly.

If you are suffering from anal fissures for the first time, the one question that is bound to bother you most would be – ‘How do you Know if a Fissure is Healing?’ When the fissure begins to settle down, the skin tag too will settle down. Deal with the skin tag once the fissure is gone is possible. You can tell you are healing when you experience lessened pain and reduced or no bleeding at all. Also, use a stool softener and try Sitz baths for faster recovery. A heating pad too can be used to stimulate blood flow to the affected area and improve recovery. Do not be concerned if you see blood even after a few weeks of treatment, as the healing process does take time.

Treatment for Immediate Relief

1. Relief from Pain

Immediate relief refers to relieving itching, irritation and burning pain associated with fissures. There are medications available that you can use, such as painkillers like ibuprofen and paracetamol. Keep in mind that you should consult your doctor to find out the correct usage procedures and dosage. In cases of extreme pain or inflammation, painkiller injections may be recommended to provide fast relief. How do you know if a fissure is healing? When the pain index dips, you can be sure your fissures are healing.

2. Relief from Itchy Anus

One of the most annoying symptoms of anal fissures is an itchy anus. It can even be frustrating as you cannot scratch the itch. To get rid of the itching, doctors prescribe certain ointments – Glyceryl Trinitrate (GTN) is a popular ointment which must be used twice a day. It helps with itching as well as burning pain. GTN ointment expands blood vessels in the rectal area, which in turn increases the supply of blood to the fissures, thereby helping in fast recovering from these symptoms.

While it is recommended that patients use GTN ointment for one and a half months, it is best to consult your doctor about how much or for how long you should use the ointment based on your case.

Your GP might recommend prolonged use based on the severity of your fissures. Almost all cases of acute fissures are cured using GTN, but you should bear in mind that using this ointment causes some side effects, such as dizziness, nausea, headaches, etc. This means that you will initially have to adjust yourself accordingly.

3. Treatment for Extreme Cases of Fissures

For chronic anal fissure, you can flip the switch for medical or surgical treatment. You will require medical treatment if you experience extreme itching and burning pain throughout the day – so severe that you cannot even sit, walk, or sleep.

Injection: Injections are a new, advanced treatment for chronic anal fissures. Botulinum toxin, popularly known as Botox, is injected to cause partial paralysis of the anal sphincter muscles. This prevents spasms in the muscles and alleviates the burning pain. It also promotes healing. The injection of the botulinum toxin is effective for two and a half months, providing ample time for fissures to heal permanently.

Surgery: Another effective solution for curing anal fissures is surgery. The majority of patients who undergo a surgical procedure to treat fissures see long-term results. However, note that there have been recurrences of fissures in some cases. One of the most popular surgical techniques for fissures is lateral sphincterotomy. That is a procedure in which the surgeon makes a small incision in the sphincter muscle ring that surrounds the anal canal.

This helps in reducing the pressure in the anal canal and fissures start healing by themselves once the pressure is reduced. The surgery begins with general anesthesia and may come with some side effects like pain and disturbance in bowel control, but these only last a short period of time.

Another surgical procedure for the treatment of chronic fissures is advancement anal flaps. But it is used very rarely in the treatment of anal fissures. It involves taking healthy tissue from another part of the body and using it to repair the affected area. Fissures start healing as blood supply in the rectum is increased. Advancement anal flaps procedure is typically recommended for curing fissures caused by trauma or pregnancy.

III. Anal fissure home treatment – Tested and Tried Home Remedies

Here is a look at the top home remedies to treat anal fissures:

i. Aloe Vera:

With its powerful pain-relieving properties and natural healing powers, aloe vera is known to be extremely effective in easing symptoms of anal fissures. It also helps in repairing damaged skin tissue caused by fissures. Aloe vera is also a salient natural treatment for chronic anal fissures.

aloe gel for fissures

Image: CC0 Public Lovesevenforty via Pixabay.

  • Scrape out the gel from 1 aloe vera leaf.
  • Apply the gel on the affected area.
  • Repeat the process a few times a day to soothe the symptoms.
  • Continue to follow the remedy until the fissures heal.

ii. Olive Oil:

How to cure fissure permanently? Try olive oil! Rich in healthy fats, olive oil helps in lubricating your bowel system, allowing stool to pass easily and painlessly. It also has anti-inflammatory properties that can help in reducing pain brought on by anal fissures. When used in combination with other ingredients, olive oil has been found to reduce itching, pain, and bleeding.

  • Mix equal parts of olive oil, beeswax, and honey in a bowl.
  • Melt the beeswax completely by warming the mixture in a microwave.
  • Allow the mixture to cool and then apply it on the affected area.
  • Repeat this a few times every day until you notice an improvement.

iii. Coconut Oil:

If you are looking for an anal fissure home treatment that relieves symptoms and stimulates the healing process, you should try coconut oil. This beneficial oil is known for having a rich content of medium-chain triglycerides, which helps in keeping the affected area well-lubricated as the oil penetrates into the skin easily. As coconut oil begins the healing process, you can be sure that the fissures will be cured.
coconut oil to treat anal fissures

Image: CC0 Creative Commons by SchaOn via Pixabay.

  • Apply organic coconut oil to the anal sphincter.
  • Do this 2 to 3 times a day. For chronic cases, apply the oil several times daily.
  • If you suffer from constipation or other types of digestive issues, add coconut oil to your diet.
  • Continue using coconut oil until you notice an improvement and the fissure is completely healed.

iv. Hot Sitz Bath:

A hot sitz bath is hands down the best anal fissure treatment you can find. It can work wonders in alleviating the pain and discomfort that are associated with anal fissures and promoting healing of the tears or cracks. It is also effective in increasing the flow of blood to the anal area, which in turn helps in healing minor splits or tears in the tissue. A hot sitz bath also helps reduce itching, pain and swelling.

  • Fill up your bathtub with warm water and add a few drops of lavender essential oil.
  • Sit still waist-deep in water for 15 to 20 minutes.
  • Do this 2 to 3 times a day.
  • Continue until you do not experience the symptoms of anal fissures any longer.
  • Note: You can also apply a warm compress after bowel movements as well as a hot sitz bath when you have time to relax and take the time to use the goodness of the bath.

v. Apple Cider Vinegar:

When it comes to home remedies for anal fissures, the list cannot be complete without apple cider vinegar. It effectively helps in treating constipation, which is one of the primary causes of anal fissures. Furthermore, apple cider vinegar contains a water-soluble fiber called pectin that can significantly help in boosting the digestive process as well as improving bowel movements.

  • Mix 1 to 2 tablespoons of raw, unfiltered apple cider vinegar in a glass of water.
  • Add a bit of honey to improve the taste if you like.
  • Drink the solution 2 times a day.
  • Continue using the remedy until you find relief from the symptoms of fissures and notice an improvement in your condition.

Other Tips

  • Maintain solid hygiene and keep the affected area clean and dry at all times as moisture can increase the risk of bacterial infections.
  • Consume more fiber-rich foods to make bowel movements easier. Include foods like legumes, quinoa, oatmeal, buckwheat, spinach, pumpkin seeds, sunflower seeds and prunes to your daily diet.
  • Drink plenty of fresh fruit juices – 3 to 4 times a day. They will help in treating constipation and softening stools as well.
  • Hydrate your body by drinking plenty of water and other fluids (avoid aerated and caffeinated beverages) throughout the day. This will help prevent constipation and soften stools.
  • Perform light to moderate physical activities for 30 minutes every day. This will improve anal blood flow and encourage bowel movement.

Anal fissures cause uncomfortable sensations that can be quite scary. However, as you have seen, there are effective medical and surgical treatments to cure the condition.

You can also use simple yet effective home remedies to ease the symptoms of fissures and heal the tears or cracks. If you do not see an improvement within a couple of weeks, you should visit your doctor and get the medical attention you need to cure the problem.


Featured Image: CC by 2.0, by Zahy1412, via Commons Wikipedia