How to treat pain from anal fissures

Nov 14, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

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.

Methods for treating anal fissure pain include warm water sitz baths, adjusting diet, improving bowel habits, topical medication for symptom relief, and surgical intervention. Appropriate treatment should be selected based on the severity of the condition, and most mild cases can be relieved with conservative management. If pain persists or worsens, bleeding becomes frequent, or signs of infection appear, prompt medical attention is recommended.

1. Warm Water Sitz Baths: Soak in warm water at 38–40°C for 15–20 minutes daily. This helps relax the anal sphincter muscle, cleanses the perianal skin, reduces inflammatory irritation, and alleviates both pain and sphincter spasm. It is especially beneficial after defecation or before bedtime.

2. Adjusting Diet: Increase dietary fiber intake by consuming foods such as celery, apples, and oats. Maintain a daily fluid intake of 1500–2000 ml to soften stools and reduce friction and irritation on the anal fissure during bowel movements.

3. Improving Bowel Habits: Establish regular bowel habits, avoid prolonged straining or sitting on the toilet (no more than 5 minutes), and refrain from excessive用力 during defecation. Use laxatives such as lactulose if necessary to prevent constipation from worsening the fissure.

4. Topical Medication: Use hemorrhoid ointments or nitroglycerin ointment as directed by a physician. The former helps reduce local inflammation and pain, while the latter relaxes the anal sphincter and improves blood flow to promote healing. These medications should be used consistently according to prescribed regimens.

5. Surgical Intervention: Recommended for chronic anal fissures, cases unresponsive to conservative treatment, or those presenting with the anal fissure triad (anal fissure, sentinel pile, and hypertrophied anal papilla). Procedures such as fissurectomy or lateral internal sphincterotomy can effectively resolve pain and promote healing.

Daily care includes wearing soft, breathable cotton underwear to minimize irritation of the perianal skin; avoiding prolonged sitting or standing; engaging in light physical activity such as walking; and gently wiping with soft toilet paper after bowel movements to maintain dryness and cleanliness of the anal area.

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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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What are the symptoms of anal fissure?

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.