How is anal fissure diagnosed?

Nov 14, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

The diagnosis of anal fissures is generally made through symptom inquiry, visual examination of the anus, digital rectal examination, anoscopy, and ruling out other diseases. The doctor will carefully inquire about the patient's symptoms, including the nature of pain during defecation, duration of pain, presence of rectal bleeding, bowel habits, and history of constipation, to make a preliminary assessment of whether the symptoms are consistent with those of an anal fissure.

Diagnosis of anal fissures is generally carried out through symptom inquiry, visual examination of the anus, digital rectal examination, anoscopy, and ruling out other diseases. The specific procedures are as follows:

1. Symptom Inquiry: The doctor will thoroughly ask about the patient's symptoms, including the nature of pain during bowel movements, duration of pain, presence of rectal bleeding, bowel habits, and history of constipation, to make a preliminary assessment of whether the symptoms match those typical of an anal fissure.

2. Visual Examination of the Anus: The patient will be positioned appropriately while the doctor examines the perianal skin for any signs of裂s, redness, swelling, discharge, or sentinel piles. In most cases of acute anal fissures, the location and appearance of the裂 can be directly observed.

3. Digital Rectal Examination: For atypical symptoms or suspected chronic anal fissures, the doctor may perform a digital rectal exam. This involves gently palpating the anal canal and lower rectum to check for tenderness or induration, assess the depth and extent of the fissure, and rule out other conditions such as perianal abscesses or hemorrhoids.

4. Anoscopy: If further evaluation of the severity of the fissure or exclusion of internal rectal pathology is needed, anoscopy may be performed. This allows clear visualization of the fissure site and associated findings such as enlarged anal papillae. The procedure is conducted gently to minimize discomfort and avoid worsening pain.

5. Ruling Out Other Diseases: Based on the above examinations, the doctor will exclude other conditions that may present with similar symptoms, such as hemorrhoids, perianal abscesses, or colorectal tumors, to prevent misdiagnosis and ensure appropriate treatment.

When symptoms suggestive of an anal fissure occur, patients should promptly visit the proctology department of a qualified medical institution, cooperate with the necessary diagnostic evaluations, follow medical advice for appropriate treatment upon diagnosis, and adjust their diet and bowel habits to promote recovery.

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Can constipation and anal fissures heal on their own?

In general, whether constipation-related anal fissures can heal spontaneously mainly depends on the type and severity of the fissure. After developing an anal fissure, it is important to first determine its type rather than blindly waiting for self-healing. In daily life, avoid prolonged sitting to reduce pressure around the anus; avoid prolonged squatting during bowel movements and keep bowel movements brief. If the anal fissure persists for more than two weeks without healing, or if symptoms such as increased pain or heavier bleeding occur, prompt medical attention is necessary.

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Is flatulence a sign of intestinal obstruction?

In general, flatulence is a normal physiological phenomenon and does not indicate intestinal obstruction. When symptoms such as abdominal pain, bloating, or abnormal bowel movements occur, diagnosis should be based on a comprehensive assessment including whether there is cessation of flatus, vomiting, and other associated symptoms; one should not rely solely on the presence or absence of flatulence to draw conclusions. Maintaining a balanced diet in daily life, avoiding overeating, reducing intake of hard-to-digest foods, and minimizing intestinal burden are recommended.

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Can patients with anal fissures run?

In general, whether patients with anal fissures can run depends on the severity of their condition and overall physical health. If there is obvious discomfort or worsening symptoms, prompt medical attention is recommended. Before running, individuals should assess their symptoms to determine the current stage of the condition. Wear loose, breathable clothing to minimize friction around the anus, and clean the anal area promptly after running to keep the area dry.

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What department should be consulted for anal polyps?

In general, the main medical departments for treating anal polyps include proctology, colorectal surgery, gastroenterology, general surgery, and emergency medicine. If you notice any abnormalities in the anal area or suspect symptoms of polyps, it is recommended to promptly visit the appropriate department at a正规 hospital for evaluation and diagnosis. In daily life, maintain good anal hygiene by cleaning the perianal area with warm water every day to reduce bacterial growth, and avoid prolonged sitting or standing.