What are the main symptoms of anal fissure?

Nov 14, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

The main symptoms of anal fissures generally include severe pain during defecation, persistent pain after bowel movements, slight bleeding on the stool surface, itching and discomfort around the anus, and worsening difficulty in defecation. Severe pain during defecation: during bowel movements, dry feces rubbing against the fissure wound irritate the nerve endings around the anus, causing intense pain, often described as sharp, knife-like, or burning.

　　The main symptoms of anal fissures generally include severe pain during defecation, persistent pain after bowel movements, small amounts of blood on the stool surface, itching and discomfort around the anus, and worsening difficulty in defecation. A detailed analysis is as follows:

　　1. Severe pain during defecation: During bowel movements, dry feces rubbing against the anal fissure wound stimulate nerve endings around the anus, causing intense pain, often described as a cutting or burning sensation. The pain may temporarily subside after stool passage but tends to recur with each subsequent bowel movement.

　　2. Persistent pain after defecation: After bowel movements, the anal sphincter muscle may spasm due to irritation from the wound, leading to a recurrence of pain. This pain can last from several minutes to hours and, in severe cases, may interfere with daily activities such as sitting or walking. Pain gradually eases only after the sphincter muscle becomes fatigued and relaxes.

　　3. Small amount of blood on the stool surface: Minor blood vessels in the fissure wound are easily damaged during defecation, resulting in slight bleeding. Blood typically appears as bright red streaks on the stool surface or spots on toilet paper. Significant dripping or mixing of blood with stool is uncommon.

　　4. Itching and discomfort around the anus: The anal fissure wound may secrete a small amount of exudate, which over time irritates the perianal skin, potentially causing local inflammation and itching. Frequent scratching can further damage the skin and even lead to secondary infection.

　　5. Worsening defecation difficulty: Due to fear of severe pain during bowel movements, patients may deliberately delay defecation, prolonging stool retention in the intestine. This leads to excessive water absorption, making stools drier and harder. Subsequent bowel movements then cause further injury to the wound, creating a vicious cycle of "pain-constipation-more pain."

　　Once the above symptoms of anal fissure appear, it is important to adjust the diet promptly by consuming more fiber-rich foods to maintain soft and smooth bowel movements. If symptoms persist for more than one week without improvement, timely medical consultation is recommended to prevent progression to chronic anal fissure.

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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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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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How to quickly relieve pain from anal fissures

Pain from anal fissures can be relieved with topical analgesic ointments, warm sitz baths, adjusting bowel habits, using lubricants, and avoiding irritation to the affected area. These measures can quickly alleviate pain and reduce further damage to the fissure site. If pain continues to worsen, bleeding increases, or signs of infection appear, prompt medical attention is recommended. Use ointments containing ingredients such as lidocaine under a doctor's guidance.

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How to treat pain from anal fissures

Treatment methods for anal fissure pain include warm water sitz baths, adjusting diet, improving bowel habits, topical medications for symptom relief, and surgical intervention when necessary. The appropriate approach should be selected based on the severity of the condition; most mild cases can be relieved with conservative treatment. If pain persists or worsens, bleeding becomes frequent, or signs of infection appear, prompt medical attention is recommended.