Anal Fissures & Fistulas

What Are Anal Fissures & Fistulas?

Anal fissures are small tears in the lining of the anus that can cause pain and bleeding during bowel movements. They are common and can be acute (short-term) or chronic (lasting more than six weeks).

Anal fistulas are small channels that form between the end of the bowel and the skin near the anus.

What Causes Anal Fissures and Fistulas?

Anal fissures result from passing hard stools, straining, or other forms of trauma to the anal canal. They can also be caused by underlying conditions like Crohn’s disease or inflammatory bowel disease.
Anal Fistulas usually result from an infection that creates an anal or perianal abscess, which is a collection of pus. The abscess drains and forms the fistula.

What Are the Symptoms of Anal Fissures and Fistulas?

Common symptoms of anal fissures include:

Pain during bowel movements
Bright red blood on stool or toilet paper
Itching or irritation around the anus
A visible crack or tear in the skin around the anus

Common symptoms of anal fistulas include:

Persistent drainage of pus or blood from the anus
Swelling and pain around the anus
Fever or chills
Pain during bowel movement

UR Medicine's Treatments for Anal Fissures & Fistulas

To diagnose anal fissures, your provider will conduct a physical examination, looking for visible tears or abnormalities in the anal canal. For anal fistulas, additional tests, like an ultrasound or MRI, may be necessary to determine the location and extent of the fistula.

Treatment for Anal Fissures may include:

Dietary changes such as increasing fiber and water intake.
Medications like topical anesthetics and calcium channel blockers.
Surgery — a lateral internal sphincterotomy can reduce anal canal pressure.

Treatment for Anal Fistulas may include:

Antibiotics
Surgery such as a fistulotomy (opening of the fistula) or seton placement (a thread left in place to help the fistula drain)

What Sets Us Apart?

Other hospitals and gastroenterologists in the Rochester region often depend on our physicians to handle their most complex and challenging cases. We are home to the only center in the region specializing in treating Inflammatory Bowel Disease. We’re actively involved in research to determine better approaches to treatment.

Our involvement with clinical trials allows patients access to advanced treatments that are not yet widely available. We regularly serve as a valuable second opinion resource for patients referred from far and wide.