Renal fissure

Your doctor will likely ask about your medical history and perform a physical exam, including a gentle inspection of the anal region. Often the tear is visible. Usually this exam is all that's needed to diagnose an anal fissure.

An acute anal fissure looks like a fresh tear, somewhat like a paper cut. A chronic anal fissure likely has a deeper tear, and may have internal or external fleshy growths. A fissure is considered chronic if it lasts more than eight weeks.

The fissure's location offers clues about its cause. A fissure that occurs on the side of the anal opening, rather than the back or front, is more likely to be a sign of another disorder, such as Crohn's disease. Your doctor may recommend further testing if he or she thinks you have an underlying condition:

Anoscopy. An anoscope is a tubular device inserted into the anus to help your doctor visualize the rectum and anus.

Flexible sigmoidoscopy. Your doctor will insert a thin, flexible tube with a tiny video into the bottom portion of your colon. This test may be done if you're younger than 50 and have no risk factors for intestinal diseases or colon cancer.

Colonoscopy. Your doctor will insert a flexible tube into your rectum to inspect the entire colon. This test may be done if you are older than age 50 or you have risk factors for colon cancer, signs of other conditions, or other symptoms such as abdominal pain or diarrhea.

Most anal fissures don’t require extensive treatment. However, certain home remedies can help promote healing and relieve uncomfortable symptoms. You can treat an anal fissure at home by:

using over-the-counter stool softeners

drinking more fluids to stay hydrated and improve digestion

taking fiber supplements and eating more fibrous foods

taking a sitz bath to relax the anal muscles, relieve irritation, and increase blood flow to the anorectal area

applying nitroglycerin ointment to promote blood flow to the area or hydrocortisone cream, such as Cortizone 10

applying topical pain relievers, such as lidocaine, to the anus to ease discomfort

If your symptoms persist after trying home remedies, you should consult your doctor, who may recommend further treatments.

A calcium channel blocker ointment can relax the sphincter muscles and allow the anal fissure to heal.

Another possible treatment is Botox injections into the anal sphincter. The injections will prevent spasms in your anus by temporarily paralyzing the muscle. This allows the anal fissure to heal while preventing new fissures from forming.

If your anal fissure fails to respond to other treatments, your doctor may recommend an anal sphincterotomy.

This surgical procedure involves making a small incision in the anal sphincter to relax the muscle. Relaxing the muscle allows the anal fissure to heal.