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What is an anal fissure?
An anal fissure (फिशर) is a small cut or split in the thin, moist skin that lines the anal canal. It usually happens when a hard or large stool stretches the opening more than it can handle. Most fissures are found at the back (towards the spine), where the blood supply is weakest.
Doctors describe fissures in two ways:
- Acute fissure: a fresh tear, present for less than about six weeks. It often heals with simple care.
- Chronic fissure: a tear that has lasted longer, sometimes with a small skin tag next to it (a "sentinel pile") and hard edges. It is less likely to heal with creams alone.
A fissure keeps itself going through a cycle: the tear hurts → the anal muscle tightens in spasm → the spasm cuts down blood flow → the tear can't heal → the next bowel movement tears it again. Treatment works by breaking this cycle.
Symptoms of anal fissure
- Sharp, cutting pain while passing stool
- A deep, burning ache that can last minutes to a few hours afterwards
- Bright red blood, usually a small streak on the stool or toilet paper
- A small lump or skin tag near the anus (in long-standing fissures)
- Fear of passing stool, which leads to holding it in, harder stools and more pain
- Itching or irritation around the anus
Painless bleeding is more typical of piles. A swelling that leaks pus suggests a fistula or abscess.
Causes and risk factors
- Constipation and passing hard, large stools
- Straining, or sitting on the toilet for a long time
- Frequent diarrhoea, which irritates the lining
- A low-fibre diet and not drinking enough water
- Childbirth, which can stretch or tear the area
- A naturally tight anal sphincter (high muscle tone)
- Less commonly, conditions such as Crohn's disease, tuberculosis or infections. These cause fissures in unusual positions, which is one reason an examination matters.
When to see a doctor
See a doctor if pain while passing stool lasts more than a few days, or if you see blood. Seek care promptly if you have:
- Heavy bleeding, or black / maroon stools
- Fever, a hot and swollen lump, or pus: this may be an abscess
- A fissure that has not healed after six to eight weeks of treatment
- Weight loss, loss of appetite or a lasting change in bowel habits
- Several fissures, or a fissure at the side of the anus (may point to another condition)
How a fissure is diagnosed at Samrijo
Most fissures can be seen by gently parting the buttocks during a private examination. Because the area is very painful, the surgeon will be as gentle as possible and may avoid an internal examination at the first visit.
- History and gentle visual examination in the OPD
- Proctoscopy later, once pain has settled, or under anaesthesia at the time of a procedure
- Blood tests at the hospital laboratory if needed, and before any procedure
- Colonoscopy if symptoms suggest another bowel condition
Treatment options
What to expect
Before
Consultation, blood tests, and a check-up with the anaesthetist if a procedure is planned. Tell the team about blood thinners and other medicines. You will usually be asked not to eat for about six hours before anaesthesia.
During
Under anaesthesia (the type is decided by the anaesthetist), a laser procedure or sphincterotomy usually takes well under an hour.
After
Many patients go home the same day. The spasm pain often eases quickly once the muscle is relaxed, though the wound itself takes a few weeks to heal. Sitz baths, stool softeners and painkillers are part of recovery.
Recovery and prevention
Desk work is often possible within a few days. Keeping stools soft for several weeks is the most important step, both for healing and to stop a new fissure. A follow-up visit checks healing.
Why choose Samrijo Hospital for fissure treatment
- Surgeon-led care by Dr. Arun Kumar Patel (MBBS, MS General Surgery).
- Non-surgical first: most fissures are treated with medicines and diet before any procedure is considered.
- Laser and conventional options under one roof, with an in-house operation theatre.
- Lab tests in the same building and a 24×7 hospital for any concern after treatment.
- Private, respectful consultations in Hindi or English.
Cost of fissure treatment
The cost depends on whether medicines are enough or a procedure is needed, the technique (laser, sphincterotomy or Botox), anaesthesia, length of stay, tests and your insurance or TPA cover.
Call 93196 62944 for an estimate after your consultation.
बुराड़ी में फिशर का इलाज
फिशर गुदा की अंदरूनी त्वचा में एक छोटी दरार है। इसमें मल त्याग के समय तेज़, कटने जैसा दर्द होता है और बाद में घंटों तक जलन रह सकती है। कभी-कभी मल पर हल्का लाल खून भी दिखता है। कब्ज़, सख़्त मल, ज़ोर लगाना और कम पानी पीना इसके आम कारण हैं।
अच्छी बात यह है कि ज़्यादातर नए फिशर बिना ऑपरेशन के ठीक हो जाते हैं: फ़ाइबर वाला खाना, दिन में 8–10 गिलास पानी, गुनगुने पानी में बैठना (सिट्ज़ बाथ) और डॉक्टर की दी हुई क्रीम। अगर फिशर छह-आठ हफ़्ते में ठीक न हो, तो Samrijo Hospital, बुराड़ी में लेज़र या छोटी सर्जरी (स्फ़िंक्टेरोटॉमी) का विकल्प है। ज़्यादातर मरीज़ उसी दिन घर जा सकते हैं, पर रिकवरी हर व्यक्ति में अलग होती है।
तेज़ बुखार, सूजन, मवाद या ज़्यादा खून आए तो तुरंत दिखाएँ। अपॉइंटमेंट के लिए कॉल करें: 93196 62944।
Frequently asked questions
Can an anal fissure heal on its own?
Yes, many fresh (acute) fissures heal within four to six weeks with softer stools, more fibre and water, warm sitz baths and medicines that relax the anal muscle. Fissures that last longer than about six to eight weeks are called chronic and may need a procedure.
Why does a fissure hurt so much?
The lining of the anal canal has many nerve endings. A tear there also makes the ring of muscle around the anus (the internal sphincter) go into spasm. The spasm causes the deep, burning pain after passing stool and also reduces blood flow, which slows healing.
Is laser treatment for fissure better than regular surgery?
Both aim to relax the tight muscle and let the tear heal. The standard operation, lateral internal sphincterotomy, has the longest track record. Laser is a newer option that some surgeons use; many patients have less discomfort afterwards, but long-term data is more limited. Your surgeon will explain which option suits you.
Will fissure surgery affect my control over stool or gas?
A small number of people notice minor difficulty holding back gas or a little leakage after sphincter surgery. This is usually mild and often improves over time. Your surgeon will discuss this risk with you and may suggest medicines or Botox first if you are at higher risk.
How long does recovery take after fissure treatment?
With medicines, relief often starts within a few days to weeks. After a procedure, many patients go home the same day and return to desk work in a few days. Full healing of the tear can take a few weeks. Recovery time varies from person to person.
How much does fissure treatment cost?
It depends on whether medicines are enough or a procedure is needed, the technique, anaesthesia, stay and tests. Please call 93196 62944 for an estimate after a consultation.
फिशर और बवासीर में क्या फ़र्क है?
फिशर गुदा की अंदरूनी परत में एक छोटा कट या दरार है, जिसमें मल त्याग के समय और बाद में तेज़, जलन वाला दर्द होता है। बवासीर में नसें सूज जाती हैं और अक्सर बिना दर्द के खून आता है। सही पहचान डॉक्टर की जाँच से ही होती है।
क्या फिशर बिना ऑपरेशन ठीक हो सकता है?
हाँ, नया फिशर अक्सर फ़ाइबर वाले खाने, ज़्यादा पानी, सिट्ज़ बाथ और मांसपेशी को ढीला करने वाली क्रीम से कुछ हफ़्तों में ठीक हो जाता है। पुराने फिशर में डॉक्टर लेज़र या छोटी सर्जरी की सलाह दे सकते हैं।
Related treatments
This page is for general health information only. It is not a diagnosis or a substitute for a consultation. Every patient is different, so please consult a qualified doctor about your own condition and treatment. Medical disclaimer.