Anal Fissure

What is an anal fissure?

An anal fissure is a “cut” or “tear” at the anus or inside the anal canal. It is a very common proctological problem.

The condition is sometimes misdiagnosed as hemorrhoids as they share several symptoms, especially when a “skin tag” is present.

Sometimes, physical examination is not enough to get an accurate diagnosis, and your doctor may need to visualize the lesion with anoscopy.

Acute Fissures may develop into chronic fissures. Over 90% of acute fissures last for a short duration and heal spontaneously or with simple self-care measures.

However, if you leave anal fissures untreated, they can become chronic and cause a myriad of problems.

Anal Fissure

Chronic fissure symptomatic

Chronic fissure pathological slow healing circulation

What are the symptoms of anal fissure?

During your initial assessment, the doctor at our clinic will investigate the possible cause of the fissure and determine its exact location. Based on a variety of factors, your doctor will determine the best course of action in the treatment of your anal fissure.

The most common symptoms of anal fissures include Pain, Bleeding, Itching, and constipation.

You can self-assess how serious your anal fissure is based on your symptoms. It is essential to treat it early instead since a slow-healing anal fissure could reduce the chances of successful non-invasive procedures.

What are the types of anal fissures?

Defined by time: Acute and Chronic

Acute Fissure – occurs with a sudden onset and healing within 2-6 weeks.

Chronic Fissure – Generally fails to heal within 8 weeks. Chronic anal fissure is inconsistent in its symptoms.

Defined by location

Most fissures are located at the back (i.e., posterior fissures), although they can also be located at the front (i.e., anterior fissures) or at the sides. Anal fissures can also be in more than one location. The location may give us a clue to the cause of the anal fissure. For example, a fissure located at the sides may be more likely due to Crohn’s disease.

Defined by number:

Singular anal fissure.
Multiple anal fissures.

Defined by disease-caused anal fissure:

Simple anal fissure.
Complicated anal fissures (e.g., anal fissures due to viral infections).

Defined by recognition:

Visible anal fissure.
Invisible anal fissure..

Who is more prone to have fissures?

Adults between 20 and 40 years old are more prone to anal fissures but it can also happen to younger patients. People who deal with some medical conditions (e.g., leukemia, cancer, ulcerative colitis, and STDs) are more likely to get it.

What are the causes of anal fissures?

Primary Causes:

** In addition to the factors listed, primary fissures may also have no clear underlying cause.

Secondary Causes:

Chronic Anal fissure secondary changes

Some facts about anal fissures

Our Anal Fissure Treatment- Guoyi Proctology Therapy

Guoyi Proctology Grading System for Anal Fissure

Grade 1: Acute fissure- Fresh cut

Within 6-8 weeks, the tear is fresh and simple, whereas elasticity is poor, so no chronic ulcer is formed. The fibers of the longitudinal muscle are exposed on the wound surface.

Grade 2: Ulcer forming stage

The wound edge is raised with induration. Wound granulation tissue is not fresh and there are apparent ulcers.

Grade 3: Ulcer formed stage

In old chronic anal fissures with a history of recurrence, the base of the fissure is deep and the wound’s margin is irregular, hard, and stiff. Complications may arise due to the inflammation. Examples include sentinel Pile, hemorrhoids, hypertrophied papillae, anal cryptitis, and subcutaneous fistula.

Grade 4: Ulcer with multiple complexities

Aside from the symptoms of grade 3 anal fissures, the fissures will cause complications, which present with superficial subcutaneous fistula and true fistula.

  • Superficial subcutaneous fistula
  • Sentinel Pile/hemorrhoid/tag
  • Anal abscess and Anal Fistula

Examination Position




Knee-chest, Side-lying

The features of Guoyi Proctology Therapy

The benefits of our anal fissure treatment

We Focus on the full solution and cure of prolonged fissures; we also assist you in determining the source or receiving additional medical care attention.

We operate minor Surgical Procedure if needed:

The treatment will be “specialized Ba Zhi San ointment” centered.

Anal fissure prevention

  • Do your best to prevent constipation or diarrhea. Get treatment for chronic constipation or ongoing diarrhea.
  • Stay hydrated. Too much alcohol and caffeine can lead to dehydration.
  • Don’t ignore your urge to go.
  • Don’t strain or sit on the toilet for too long.
  • Gently clean and dry the anal region after each bowel movement.
  • Avoid irritants to the skin, such as scented soaps or bubble baths.
  • Use our clinical 20ml Enema when you feel you have to push very hard.
  • Immediate self-care when acute fissure happens.
    1. Do the Sitz baths for 5 minutes after the Bowel Movement.
    2. Apply MaYinLong Cream on the visible tear.
    3. Registered patients can call N.A. Hemorrhoid Clinic Service Line for personalized management.

We can help you

We specialize in anorectal diseases and offer therapies for the treatment and prevention of hemorrhoids, anal fistulas, anal fissures, anal abscesses and anal itching caused by anal eczemas.

Fill up the form below and our friendly staff members will get back you you shortly to arrange an appointment that works best for you.

Caring doctor holding patient's hand

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