Is anal fissure prone to recurrence?

Written by Wang Ji Zhong
Internal Medicine
Updated on April 15, 2025
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Anal fissures are prone to recurrence, and the main reasons for recurrence are prolonged sitting or standing, leading to relaxation of the intestinal muscles and insufficient motility, which can cause constipation. During bowel movements, the damaged area can be scratched, resulting in anal fissures. Due to excessive strain, mental stress, and physical fatigue, metabolism can be affected, leading to indigestion and constipation, which can cause anal fissures. Sometimes irregular eating habits and consuming spicy, greasy, and irritating foods can cause constipation, thus aggravating the fissure and leading to its recurrence. An imbalance in intestinal flora can impair digestion and cause constipation, leading to anal fissures. The fundamental treatment for anal fissures is surgical intervention.

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Written by Chen Tian Jing
Colorectal Surgery
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Anal fissure bleeding symptoms

The most common clinical symptoms of anal fissure, apart from the intense tearing pain in the anal area, include bleeding during bowel movements. The bleeding from anal fissures is typically bright red, and the amount of blood can increase with the severity of the condition due to repeated stretching of the fissure. Particularly during acute episodes of anal fissures or after defecation, bleeding from the local fissure can be more significant. Patients with bleeding anal fissures generally have a history of dry stools, so the first step in treating anal fissure bleeding is to lubricate the stool. Additionally, topical medications should be applied to the bleeding fissure to promote healing, and hemorrhoid creams with hemostatic properties can be used locally to help stop the bleeding. (Please use medications under the guidance of a professional physician, and do not self-medicate.)

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Written by Hu Xiang Dang
Colorectal Surgery Department
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What should be paid attention to usually for anal fissures?

What should I pay attention to for anal fissures? Friends who suffer from anal fissures should note the following: Firstly, pay attention to your diet. Adjust your diet structurally to be diverse. Drink plenty of water and eat less spicy and stimulating food; abstain from alcohol and betel nuts; eat less spicy hot pot and similar foods. Also, maintain a smooth bowel movement. We should develop a habit of defecating regularly, and treat constipation correctly. However, in treating constipation, we should not misuse laxatives and should use medications under the proper guidance of a doctor. We should also pay attention to keeping the anal area clean and hygienic by washing it after each bowel movement. After defecation, it is best to perform sitz baths using salt water, traditional Chinese medicine pain relievers like Shen Tang, or potassium permanganate solution. This helps in the recovery of the anal fissure. In addition to the above, we should also engage in appropriate activities. Friends with anal fissures can perform anal muscle contractions, such as Kegel exercises or stretching exercises.

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Written by Chen Tian Jing
Colorectal Surgery
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What causes anal fissures?

Anal fissure is a series of clinical symptoms such as pain or rectal bleeding that occur due to the formation of a crack in the local sphincter muscle of the anus. The main reason for the occurrence of anal fissures is due to poor defecation habits in the early stages of the patient, or excessively dry stools, and excessive force during defecation, causing the local sphincter to burst, resulting in the fissure opening pain or bleeding. To treat anal fissures, it is first necessary to soften the patient's stools and adjust defecation habits. If the patient's diet is poor, it is recommended to maintain a light, easily digestible diet long-term. For those with dry stools, appropriate oral medications to lubricate the intestines and facilitate bowel movements can be used, or sesame oil can be applied around the anus before each defecation to lubricate the stool. If recurrent episodes of anal fissures occur, surgical treatment can also be directly performed. (Medication use should be under the guidance of a doctor.)

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Written by Deng Heng
Colorectal Surgery
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Characteristics of anal fissure with bleeding

An anal fissure is a small ulcer formed by the full-thickness splitting of the skin of the anal canal below the dentate line. A characteristic of bleeding due to an anal fissure is that it generally occurs along with periodic, tearing-like pain. Thus, bleeding and pain are the main clinical manifestations of an anal fissure. During defecation, the damaged surface can lead to bleeding from the fissure, usually with a small amount of blood. The stool may have streaks of blood, or there might be a few drops of fresh blood after defecation, or a slight smearing of fresh blood on toilet paper during wiping.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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Is anal fissure serious?

People often ask whether anal fissures are serious and what the consequences might be if they are not treated. Although treating anal fissures is not particularly difficult clinically, many patients, due to a lack of treatment knowledge and awareness of the condition, often delay treatment, which can cause some harm to their health. If an anal fissure is not treated, in addition to the pain during bowel movements and bleeding that the fissure itself causes, over time, it could also lead to conditions such as anal fistula and hypertrophied anal papillae. At the end of the fissure, a sentinel pile may develop. Due to the repeated irritation by fecal matter in an inflamed fissure, a linear ulcer may form. The skin and subcutaneous tissue around the anus might undergo fibrosis, thickening, or. form a hard lump. If the fissure repeatedly becomes infected, it can lead to the development of an anal sinus, and after infection, it may cause subcutaneous fistulas or abscesses. Of course, if an anal fissure persists over time, due to long-term spasm and fibrosis of the internal sphincter, it can lead to consequences such as anal stenosis.