Anal Fissures and Stress: How Are They Related

Medically reviewed by: Gary H. Hoffman, MD

Why Do I Hurt?  What Is An Anal Fissure?

“I have pain.”  “My rear end hurts!”  “It’s killing me!!!”   These are common complaints heard by every proctologist (also known as a colon and rectal surgeon or coloproctologist), every day in big cities. Big cities, stress and anal fissures.  Los Angeles.  Fissures.  All day, all week.

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An anal fissure is a small cut or tear at the anal opening.  It is usually located in the back of the anal opening, but may also be located in the front, or, rarely, on the sides. The fissure can be superficial and shallow, or it can be deep and into the anal sphincter muscle.  Either way, it hurts.  It is best to understand and treat your fissure early before an operation is required.  Although the operation may be quick, and performed in an outpatient setting such as a surgicenter or at Cedars-Sinai Medical Center, it is always preferable to avoid operations.  Keep reading.

How Did I Get An Anal Fissure?

You did not do anything wrong to bring on this grief.  Or maybe you did.  Most often, patients report no unusual conditions that brought about the pain and the fissure.  The fissure may simply be a fact of life.  A fact related to the constant opening and closing of the anus as stool exits.  Sometimes however, a hard stool (“It was rock hard doc.”), or a bout of diarrhea (“Man, this started in Mexico.”) preceded the misery.  And, don’t forget stress. There is nothing like prolonged stress to help clench your anal sphincter muscle and contribute to the fissure formation.

But maybe you did contribute to the situation.  Have you ever cleaned your anal area with soap?  Many people do in an attempt to “polish it clean”, to quote a famous British proctologist.  Soap.  You wouldn’t put it in your eye.  It was probably pretty painful to your anus too.  And, what about the sports section or the comics.  Or, for women, the latest fashion journal.  Have you ever spent the better part of the morning sitting on the toilet reading enjoyably?  Prolonged gravity with pushing is not your friend when sitting on the commode.

The Fissure.  You Have It.  What Next?

Most often, if you stop the offending activity, the fissure may heal itself.  So:

  • No soap of any kind on the anus. Use water or baby wipes.  No soap!
  • Try to reduce the stress in your life.  Try it.  You’ll like it.
  • No reading the comics on the toilet
  • No reading the sports section on the toilet.
  • No reading the latest women’s fashion journal on the toilet.
  • Sit.  Wipe.  And go.
  • Drink plenty of water during the day.  An occasional stool softener might help.  There are many safe, over the counter softeners available.
  • For occasional diarrhea, an over the counter, anti-diarrheal medication such as Imodium® might help

And If All Of This Fails?

It may be time for a visit to the proctologist.  There are many prescription ointments that your physician can prescribe that will heal the fissure.  But, you need to see the proctologist first, BOTH to be sure that your symptoms are not related to something more serious AND to have a confidential, quiet talk and exam to assess the state for your anus.

Los Angeles Colon and Rectal Surgical Associates.

You will find advice and relief from your doctor.  At Los Angeles Colon and Rectal Surgical Associates, board certified physicians will help you understand and treat your fissure.  Appointments are available by calling (310)273-2310.  Many online pre-appointment forms are available.

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