Sharp pain when passing stool · Bright red blood
An anal fissure is a small tear in the lining of the anus. It is one of the most common causes of severe anal pain — and one of the most often mistaken for hemorrhoids. The treatment is not the same.
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The telling symptom is pain when passing stool: sharp, like a cut or broken glass, starting during the bowel movement and often lasting minutes or hours afterwards. There is usually bright red blood on the paper or on the stool, not mixed into it.
Many people start delaying going to the bathroom because of the pain. That makes the stool harder and reopens the fissure — that is the cycle that has to be broken.
The usual cause is passing hard or bulky stool, most often from constipation. It also appears after bouts of diarrhoea, after childbirth, or alongside other conditions. A fissure that has not healed in a few weeks is called chronic, and there is usually a spasm of the sphincter keeping it open.
Most fissures heal without surgery. Initial treatment softens the stool and relaxes the sphincter: fibre, water, sitz baths and topical medication. That resolves a good share of acute cases.
Surgery is considered when the fissure has become chronic, when pain persists despite treatment, or when it keeps coming back. The usual procedure is a lateral internal sphincterotomy, which releases the spasm so the tear can close.
Which one applies to you is decided after examining you, not before.
No. Hemorrhoids are dilated veins; a fissure is a tear in the lining. They get confused because both bleed bright red, but fissure pain is far more intense and happens right when passing stool. Treatment differs, which is why it is worth being examined rather than self-treating.
No. Most acute fissures heal with medical treatment: fibre, water, sitz baths and topical medication. Surgery is considered when the fissure becomes chronic or does not respond to that treatment.
Yes. Assessment and, if needed, treatment can be done here, and the consultation and written instructions are in English. If you are travelling soon, say so at the consultation: it changes what is advisable and when.
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