Can you have intercourse during an anal fissure?

Written by Yu Xu Chao
Colorectal Surgery
Updated on February 11, 2025
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During an anal fissure, it is possible to have sexual intercourse without any impact on the fissure itself. For patients with an anal fissure, the main focus should be on maintaining smooth bowel movements and avoiding dry and hard stools to prevent irritating the wound, which can cause pain and bleeding. It is also important to avoid diarrhea, as frequent bowel movements can irritate the wound over time and worsen the fissure. Clinically, for early-stage anal fissures, conservative treatment with medications is often recommended, along with softening the stool. Commonly used medications include Dragon Balm ointment or nitroglycerin ointment. After defecation, patients can opt to use an anal wash or a potassium permanganate solution for sitz baths. However, for chronic anal fissures, it is generally advised to undergo fissure excision surgery as soon as possible, followed by regular dressing changes to promote healing of the wound. If an anal fissure is left untreated for a long time, it can lead to slight narrowing of the anal canal, which requires significant attention.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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symptoms of anal fissure

What are the symptoms of an anal fissure? The most typical symptoms of an anal fissure are clinically manifested in three aspects: pain, rectal bleeding, and constipation. Firstly, constipation: Many patients with anal fissures generally first exhibit symptoms of constipation. Then, due to the dryness and bulkiness of the stool, the skin around the anus tears, forming an anal fissure. Subsequently, because of anal pain, the patient fears defecation, which over time exacerbates the hardness of the stool. As constipation worsens, it can aggravate the fissure, thereby creating a vicious cycle. The second main symptom is pain, which is not only the most significant symptom of an anal fissure but also potentially the most intensely felt by the patient. The skin around the anus is sensitive, and damage to this skin can cause significant pain. The degree and duration of the pain can also indicate the severity of the fissure. Typically, the pain from an anal fissure is cyclical. It usually occurs during defecation, followed by a few minutes of relief. Then, pain is stimulated by the contraction of the internal anal sphincter, causing sustained spasms of the sphincter, leading to severe pain. This pain can last for several minutes or even hours. During this time, the patient may feel extremely uncomfortable and find it unbearable, some only finding relief when the sphincter muscles relax after fatigue. Then, the pain reoccurs with the next bowel movement, characterized by its cyclic nature. The third main symptom is rectal bleeding. Patients may notice droplets of blood during defecation, sometimes spotting a few drops of bright red blood in the toilet bowl or seeing streaks of blood on the stool, occasionally mixed with intestinal mucus. When wiping the anus, sometimes the toilet paper shows red blood. However, the amount of bleeding is related to the size and depth of the fissure—the larger and deeper the fissure, the more bleeding occurs. Additionally, some patients may experience itching around the anus. The ulcerated surface of the fissure, along with secretions from the anal glands, irritates the skin around the anus, which can lead to perianal eczema and itching.

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Written by Chen Tian Jing
Colorectal Surgery
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How to treat anal fissures and constipation?

Anal fissures and constipation are generally accompanying symptoms. When the stool is dry, the patient exerts excessive force during defecation, causing the stool to tear the local anal sphincter and mucosa, resulting in an anal fissure. Prolonged and recurrent anal fissures, due to the contraction of the local anal sphincter, can make defecation difficult for patients, or, because of the severe pain during defecation, patients may avoid defecating. This leads to stool remaining in the intestinal lumen for too long, causing the stool to dry out and further inducing constipation. To treat anal fissures and constipation, it is first necessary to lubricate the stool. One can take oral medications for lubricating the intestines and easing bowel movements or use topical lubricants. Treatment can also be complemented with anal dilation therapy or surgery through endoscopic incision, and applying a traditional Chinese medicine hot compress to the local fissure.

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Written by Chen Tian Jing
Colorectal Surgery
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What should I do about anal bleeding and anal fissures?

If a fissure is visible to the naked eye at the anal sphincter during a digital rectal examination, it is primarily considered an anal fissure. Anal fissures generally cause severe local pain and bleeding from the fissure. The fissure is primarily due to the local crack being stretched or opened, causing bleeding from small blood vessels, and the blood from the fissure is usually bright red. To treat bleeding from an anal fissure, it is first necessary to soften the stool, as the occurrence of an anal fissure is mainly related to dry stools and difficulty defecating. Once the stool is lubricated, it can reduce the need to exert excessive force during defecation, lowering the possibility of stretching the local fissure. Topical application of hemorrhoid cream at the fissure, or combined with oral medications that cool the blood and stop bleeding, may be used. If there is repeated bleeding from an anal fissure, surgical treatment is also recommended. (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 Wang Ji Zhong
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Is anal fissure prone to recurrence?

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.