What are the symptoms of anal fissure?

Nov 14, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

During an anal fissure episode, typical symptoms include severe pain during defecation, persistent pain after bowel movements, blood on the stool surface, itching around the anus, and difficulty passing stool. When patients with anal fissures pass bowel movements, dry feces rub against the fissure wound, stimulating nerve endings and causing intense pain, often described as burning or cutting in nature. The pain usually temporarily subsides after defecation ends.

When anal fissures occur, common symptoms include severe pain during bowel movements, persistent pain after defecation, blood on the surface of stool, itching around the anus, and difficulty passing stool.具体分析如下：

1. Severe pain during bowel movements: During defecation, dry stools rub against the anal fissure wound, stimulating nerve endings and causing intense pain—often described as burning or cutting in nature. The pain typically subsides temporarily after bowel movement ends but tends to recur frequently.

2. Persistent pain after bowel movements: After defecation, 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 walking or sitting. Pain gradually eases only after the sphincter muscle becomes fatigued and relaxes.

3. Blood on the surface of stool: Damaged blood vessels at the site of the fissure may bleed slightly during bowel movements. The blood usually appears bright red, coating the surface of the stool or spotting toilet paper. Bleeding is generally minimal and does not present as heavy dripping or blood mixed within the stool.

4. Itching around the anus: The anal fissure wound may secrete small amounts of fluid, which over time irritates the perianal skin, potentially triggering local inflammation and causing itching. Patients may unconsciously scratch the area, worsening skin damage or leading to infection.

5. Difficulty with bowel movements: Due to fear of severe pain during defecation, patients may deliberately delay going to the bathroom. This prolongs stool retention in the intestines, allowing excessive water absorption, resulting in harder and drier stools. Subsequent bowel movements further aggravate the anal fissure, creating a vicious cycle of "pain → constipation → worsened pain."

Upon experiencing symptoms suggestive of an anal fissure, it is important to adjust diet promptly by consuming more fiber-rich foods to maintain soft and regular bowel movements. If symptoms persist for more than one week without improvement, timely medical evaluation and treatment are recommended.

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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.