An anal fissure, which is a crack or tear in the lining of the anus, is a common but painful condition. Anyone can experience one, but they often affect pregnant people and those over 40.
At his practice in Los Angeles and Glendale, California, board-certified colon and rectal surgeon Robert G. Yavrouian, MD, specializes in anal fissure treatment. Keep reading to discover common causes of anal fissures and what you can do to reduce your risk.
Several factors can trigger anal fissures, including:
Constipation is the leading cause of anal fissures and can result from diet, certain medications, dehydration, and lack of exercise. Hard bowel movements increase the risk of tearing the anal lining.
Fortunately, several steps can help promote “regularity.” We recommend eating plenty of fiber, exercising at least 30 minutes daily, and drinking plenty of water. If your medications cause constipation, let us know. We may be able to recommend alternatives.
Do you strain when having bowel movements? Even if you aren’t constipated, straining puts extra pressure on the anal lining, increasing the risk of a fissure.
Proper toilet posture makes straining less likely. For the best results, position your knees higher than your hips with a footstool. This mimics a squatting position and lets you pass stool more easily.
Between 1% and 5% of Americans have chronic diarrhea or loose stools. Diarrhea often contains more stomach acid and digestive enzymes than normal bowel movements, and the frequency at which it occurs increases the risk of anal irritation and tissue damage. It also dries out your skin, making fissures more likely to form.
Diarrhea can be challenging to prevent, but eating bland, low-fiber foods may help. For example, the BRAT diet (banana, rice, applesauce, and toast) improves digestion and produces firmer stools. We also recommend avoiding irritants, such as caffeine and alcohol, which often make diarrhea worse.
Certain sexual activities, like anal sex and inserting objects into the anus, increase the risk of fissures. You don’t have to give up your sex life, but you should make an effort to protect the delicate tissue around the anus. To do this, use plenty of water-based lubricants and avoid overly aggressive intercourse. Likewise, tell your partner if something is painful.
The anal sphincter experiences significant pressure during vaginal delivery, which can damage the delicate lining of the anus. This isn’t a risk for every pregnancy, but it’s more likely with large babies and difficult deliveries. The fact that many new moms also experience constipation can make the problem worse.
While there’s no way to prevent excessive pressure during childbirth, you can take steps to prevent constipation afterward. For example, we recommend drinking plenty of water and eating a high-fiber diet to make passing stool easier.
Anal fissures are painful and can make routine activities, like driving and sitting for long periods, uncomfortable. If you regularly experience anal fissures, contact Robert G. Yavrouian, MD, by calling the nearest office or booking an appointment online today.
