Anal fissures commonly occur from straining during bowel movements when passing large or hard stools. Similarly, chronic constipation and diarrhoea may place excessive pressure on the anal canal, causing it to stretch and tear. Other causes of anal fissures include:

• Childbirth
• Poor blood flow to the anus
• Tight or spastic anal sphincter muscles

Although an anal fissure is not a life-threatening condition, it does come with complications that can affect overall quality of health and life. These are:

• Inability to heal – Most anal fissures heal by themselves in a week or two, but in some instances, they don’t. These are considered chronic fissures that require medical or surgical intervention.
• Recurrence – Anal fissures can return after healing.
• Anal stricture – The presence of scar tissue or a spastic anal sphincter may cause the anal canal to become narrow, which impedes the regular passage of stools.

Most cases of anal fissures can be treated at home with stool softeners and sitz baths, and simple diet and lifestyle modifications. These include sticking to a high-fibre diet to avoid constipation, keeping hydrated during the day and not straining or sitting on the toilet for a prolonged period.

If the anal fissures still do not improve after two weeks, you should seek medical attention.

Initially, medications are given to reduce pain and inflammation, relax the sphincter, improve blood supply to the anal area and encourage healing.

Surgery is the best option to treat severe anal fissures that are not responsive to diet and lifestyle changes and medications.

The steps taken to prevent anal fissures are similar to the steps taken to avoid constipation. They include:

• Eating high-fibre diet
• Drinking plenty of fluids
• Exercising regularly
• Cleaning the anal area and keeping it dry
• Changing diapers frequently (for infants)

While anal fissures cannot always be avoided, simple diet and lifestyle modifications can greatly reduce one’s risk of developing it more often.