A crack or split in the superficial skin at the anal opening is called an anal fissure. Occurring most often in children, an anal fissure is the most common cause of childhood rectal bleeding. Most often they are caused by constipation, but may occur because of inflammatory bowel disease, infection, or some abnormality. Anal fissures may also be caused by excessive wiping, anal irritation from dirty diapers, or scratching.
Symptoms may include:
Sharp anal pain with or after a bowel movement
Bright red blood (a few streaks or flecks) on the stool surface or on the toilet tissue after wiping
Visible superficial skin tear at the anal opening, painful to touch
Dull ache in the rectal/anal area following bowel movement
What your doctor can do:
Diagnose the problem by asking about your symptoms and medical history, and performing a physical exam.
Recommend stool softeners.
Prescribe an antibiotic if there is an associated bacterial infection.
Recommend surgery for fissures that recur or fail to heal.
What you can do:
Take sitz baths several times a day. Fill the bath tub with warm water mixed with salt or baking soda.
Cleanse the area with water (no soap) and pat dry instead of rubbing.
If there is irritation of the anal skin, apply non-prescription hydrocortisone cream.
If there is severe pain, apply topical anesthetic ointment several times a day for a few days.
Avoid constipation by increasing the amounts of fresh fruits and vegetables, beans, and whole grain and bran products.
Drink plenty of water each day and reduce the amount of milk and cheese you consume.
What you can expect:
Most anal fissures heal completely after constipation is corrected and stool is softened.
Possible complications include inflammation, infection, and recurrent fissures resulting in scarring.
Contact your doctor, if you still have discomfort or bleeding after treatment.