Chronic Anal Fissure – Home Remedies for Anal Fissure

Pain Chronic Fissure

About a Chronic Anal Fissure

I am going cover ways to try help you out if you are suffering from a Chronic Anal Fissure. Not everything will work for everybody and everybody is different, but there are some basic things you can try do, some natural home remedies which you may already have in your kitchen like Coconut Oil, Manuka Honey and so forth. I am not going to try substitute any medical advice and advise you still to go see your doctor and specialist if your condition continues and to consult a professional.Boy sitting on potty

Realize that most chronic anal fissures will generally recover within 2 weeks. Avoid any kind of straining, never ever strain and let it come naturally. As soon as you need to go, go, do not wait as the longer you wait even for 10 minutes, the worse it gets, practise these simple principles and it will make things are less painful over the long run.

Don’t Ignore Your Urge to Go

If your body tells you it’s time to have a bowel movement, don’t put it off till later. Waiting too long or too often can weaken the signals that let you know it’s time to go. The longer you hold it in, the dryer and harder it can get, which makes it tougher to pass.

What is a Chronic Anal Fissure?

A chronic anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus.

A Chronic Anal Fissure may occur when you pass hard or large stools during a bowel movement. Chronic anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter).

Chronic Anal Fissures are very common in young infants but can affect people of any age. Most chronic anal fissures get better with simple treatments, such as increased fiber intake or Sitz Baths. Some people with chronic anal fissures may need medication or, occasionally, surgery.

Girl squatting on potty


Signs and symptoms of a chronic anal fissure include:

  • Pain, sometimes severe, during bowel movements
  • Pain after bowel movements that can last up to several hours
  • Bright red blood on the stool or toilet paper after a bowel movement
  • Itching or irritation around the anus
  • A visible crack in the skin around the anus
  • A small lump or skin tag on the skin near the chronic anal fissure


Personal Experience

For the record I was a chronic anal fissure sufferer myself and dealt with over a year’s of chronic pain until I realized a few things during my experience but mainly is that you have to learn to manage your chronic anal fissure verses focusing on trying to cure it. I couldn’t sit, walk, sleep, lie down without being in excruciating pain. A number of people will have a mild chronic anal fissure and it will cure within 2 weeks (you are the very lucky bunch).

I suspect if you here reading this, you are a chronic anal fissure sufferer like myself asking why nothing seems to work and why the insufferable pain continues. I have tried many home and doctor-directed remedies without success, nothing seemed to work. I saw two Proctologists who had different ointments and methods for treatment. I will talk about these and the various home remedies, sitz baths and the various things I tried and hopefully, some of them will help you.


Acute vs Chronic Anal Fissure

90% located in the posterior anal canal. Acute vs Chronic. Acute: small tears in anal mucosa. Usually, respond to medical treatment. Resolve within 4-6 weeks. Chronic: present for longer periods of time. Associated with sentinel tags, rolled mucosal edges and hypertrophic anal papilla at fissure apex. Less likely to heal with medical management.

Before we get too deep into the article, there were three main things that I felt helped me in the long term.

1) I learnt to drink a lot of liquid once I realized it helped me pass stools easier. It was a bit of an epiphany because it was so obvious that I missed it. I was more focused on getting stool softeners that I missed the obvious.

2) I was taught various exercises by an Osteopathy Centre who practises Osteopathy, one of those excesses which I will call The Table Method which best describes it albeit not the proper name (Basically the just of it is treat your butt like a table when you sitting) helped me a lot as I didn’t realize I was not. I will talk later about exercises, but keeping your butt stretched out at all times whenever you sit even if painful, over time strengthen muscles and reduced the pain.

3. A medication that lowers your blood pressure. Hear me out, the way this is supposed to work is it causes your blood pressure to heal in other places. As a not the ointments prescribed but your doctors do exactly the same thing but in the form of a lotion or paste. If your doctor did prescribe something to you, he/she likely told you that you would experience headaches basically because it is lowering your blood pressure.

The tablets I took did the same thing but you swallow them, a heck of a lot nicer to apply. The medication I am talking about is Diltiazem 180MG. Speak to your doctor about it and discuss whether it is right for you. I know you going to be hesitant to try take this, but this basically got rid of the pain. It was prescribed by an experienced pain doctor at one of the largest hospitals in the area and here is a reference on



The two other creams that I tried, but didn’t actually work for me, but may you. Chances are you already have been prescribed one or the other


Here some products you may want to consider trying, some may work, some may not. Personally, I have tried the Honey and Coconut Oil. It’s going to vary from person to person and may work for you before you rule it out.

Product Description Go to Site
Carex Sitz Bath

Carex Sitz Bath

  • Ideal for use in hemorrhoid treatment, episiotomy recovery and other conditions in the anal and genital areas
  • Features a  convenient on/off flow control clip
  • Fits all standard toilets
  • Not for use in autoclave
  • Round Medical Seat Cushion

    Round Medical Seat Cushion

    Joykit Inflatable Vinyl Ring Round Seat Cushion Medical Hemorrhoid Pillow Donut
    Hemorrhoid Fissure Ointment

    Hemorrhoid Fissure Ointment

    Doctor Butler's Hemorrhoid & Fissure Ointment...FDA Approved Relief & Healing Formula (also contains Organic Herbs, Minerals and Amino Acids)
    100% Raw Manuka Honey

    100% Raw Manuka Honey

    Wedderspoon 100% Raw Manuka Honey - KFactor 16 - 8.8 oz
    Viva Coconut Oil

    Viva Coconut Oil

    Viva Naturals Organic Extra Virgin Coconut Oil, 16 Ounce
    H-Fissures Formula

    H-Fissures Formula

    The homeopathic ingredients in H-Fissures Formula have been carefully selected to counteract the uncomfortable symptoms of fissures. For example Chamomilla assists with painful fissures and Calendula officinalis is a remarkable healing agent.* H-Fissures Formula contains anti-inflammatory and antibacterial constituents. When used as directed, it will help reduce swelling associated with anal fissures. In addition, the analgesic component in the formula helps to alleviate the extreme pain that often accompanies anal fissures so that you can once again have a bowel movement without any discomfort or fear of pain

    Water, Water, Water …


    It’s incredibly important to drink lots of fluids. I know it is very difficult consuming water (at least for me), so if you can’t consume water, consume a liquid that you do like such as Fruit Juice even if it is unhealthy for now. Try to consume more health conscience liquids if you can, but bottom line, consume as much liquid in a day as possible, this can be Water, Soup, Juice, Smoothies, avoid things like alcohol as it dehydrates your body or takes in moderation just like anything else.


    Water Infographic


    Stool Softeners and Liquid Intake

    *This is important to understand & read*

    Let’s talk about stool softeners and if they are harmful to you long term. The risk of problems from long-term use of stool softeners such as docusate sodium (Colace, Regulax SS, other brands) really isn’t the issue. The question is whether they do much good. Studies have cast doubt on the effectiveness of preparations taken expressly for stool softening. Besides, there are plenty of other ways to accomplish the same thing. The difference between a hard stool and a soft one is its water content.

    I personally felt stool softeners did not work well at all, when I initially took them, they worked for the first little while and then stopped work. They expensive and personally I think not healthy to take long time. It also does not help your chronic anal fissure recover if you constantly taking stool softeners, avoid. But if you need to take them, then use some initially and then stop.

    Increasing your fiber intake can help soften stool because fiber pulls water into the intestine. Many of us get only a small fraction of the 20 to 35 grams of fiber we’re supposed to eat each day. Fruit, vegetables, and whole grains are good sources. Fiber can produce abdominal cramps, bloating, and flatulence, so it’s best to increase your intake nice and gradually.

    You body will get climatized to stool softeners and they really aren’t effective for longer than a week or so. This is the important part and took me a very LONG time to realize this. The secret to soft stool is drinking lots and lots of liquids, this can be water or this can just be liquids that you enjoy. I found it difficult to drink 8 glasses of water a day. I tried various things to try remind me to drink water. I put a water bottle on the desk and even though it was in front of me, I still didn’t feel like drinking it. It really doesn’t matter what liquids you drink, just drink liquids.

    Water Lightbulb


    Some examples of liquids are

    • Milk with your cereal
    • Water (keep it to half a glass, you don’t have to force yourself to drink a whole glass, this will make it easier, but do try drink at least 3 glasses or a more a day if possible but break it up in smaller doses)
    • Fruit Juice
    • Healthy Fruit Smoothies
    • Tea (Herbal / Caffeine free is best)
    • Coffee (try avoid too much coffee as it has caffeine and is supposedly not good for chronic anal fissures). 1 – 2 Cups a day in moderation should be fine. 

    All of these will ultimately help your stool soften. Bear in mind it takes while to become climatized to liquids, but stick with it, try drink as much liquid as you possibly can. This is what I typically do, but try drink more if you can, at minimum you should be drinking in the Morning, Noon and Dinner.

    My liquid schedule and this made things a lot better for me

    • Wake up in the morning before breakfast (Drink half a glass of water). I leave a glass on the kitchen counter to remind me to drink water when I see the glass.
    • Eat Cereal (Filled with half a glass of milk or more)
    • Lunch I have a glass of Happy Planet Smoothie (find something you enjoy drinking even if it is not water)
    • Drink half a glass of water in the afternoonHappy Planet Green Smoothie
    • Dinner I have a glass of the Happy Planet Smoothie or Soup
    • After dinner, I have a cup of Tea before bedtime
    • After I wash my teeth, I have another half a glass of water and just before bed, I may have some more water.


    I found if I broke up the routine of forcing myself to drink liquids it was easier to consume. The main point here is to make sure you drink LOTS and LOTS of liquids and I promise you, if you do and keep it consistent, it will keep your stool soft and things will run smoothly and become easier over time.

    Anal Fissure Presentation


    Are You Exercising? It Can Help You ‘Go’

    We’ve covered the importance of nourishing a healthy gut environment with beneficial bacteria, fermented foods, and sugar avoidance, while eating plenty of fiber-rich vegetables. This is a large part of the picture, but it’s not the whole thing. Exercise is also important for regularity, in part because your abdominal and intestinal muscles work together to help move your bowels. If these muscles are weak, you’ll have a harder time with bowel movements. In addition, movement helps stimulate circulation and intestinal function, causing your bowels to move properly.


    I know you are probably saying to yourself, “Exercise?  Does he know just how much pain I am in?” Or something along those lines.  I have to tell you though, it was probably the lack of exercise that caused my own health problems in the first place.Walking Exercise

    What I have learned is that it is never to late to start exercising and it really does benefit your overall health, both physically and mentally.  Now, since you have an chronic anal fissure your options when it comes to exercising are somewhat limited, but there are still plenty of exercises you can do that will aid your body in the healing process.

    Exercise promotes better cardiovascular health, which helps your heart pump more blood to your bodily organs.  This is so important as your anus is one area of your body that does not get as much blood flow as other areas.

    The reason doctors prescribe Nitroglycerin is because it helps draw blood to your anus when applied, which in return is supposed to help your body heal faster.  I can tell you from my experience using Nitroglycerin ointment that it did ABSOLUTELY NOTHING but give me a headache each time I used it!

    It is important to note that not all forms of exercise are advisable while having an Chronic Anal Fissure.  Here is a list of some recommended exercises and those that you want to avoid.  As with any form of exercise, it is always important for you to check with your doctor before starting any exercise program, especially under these circumstances.

    Good exercises for you while healing from your chronic anal fissure:

    • Walking
    • Yoga
    • Kayaking/Canoeing
    • Stretching
    • Doing some light housework or gardening

    Exercises to avoid while healing from your chronic anal fissure:

    • Biking
    • Heavy weight lifting
    • Contact sports or ones that require a lot of running
    • Any form of exercise that will cause you to strain in performing the exercise


    Table Mountain, Cape Town, South Africa

    The Table Method (important)

    One thing that help me a lot, when I would sit for long periods of time, I would feel my butt feel like there is a lot of pressure on it and cause additional pain. Probably because you suffocating all the blood vessels. Try not let your buttocks tighten up whenever you sitting pull your checks apart. Initially this is going to be painful, but you need to treat your butt like a plateau or table. It MUST be flat and spread out, over time if you continue doing this, it will strength your muscles, the idea is to get your buttocks back to normal.

    Body Sitting Down Green Arrows pointing outwards

    Pull your butt cheeks apart in the opposite direction from your body. Left cheek to the left and right cheek to the right. Keep them stretched the entire time while you sitting.

    How to do this ? Wear lose clothing when at home, this method doesn’t work well with jeans, but I have done it with jeans either by shifting around or reaching in with my hands and pulling my left cheek to the left and my right cheek to the right. Do this every time you sit down, you will feel it stretching, and just think about keeping your butt flat like a table, sit up straight. If you in a little bit of agony, you doing it right. Keep it stretched. If you in public and can’t put your hands in your pants, then just shift you butt on the chair and use your butt to pull your cheeks apart, this works with jeans.

    Round Medical Seat Cushion Also consider getting additional pillows or a ring cushion to sit on when you are sitting if you still in pain, this will also help. I personally sit on a pillow even today and it does make a huge difference. Avoid sitting on a hard chair if possible and always sit on something soft when you are at home. Even though my couch is relatively soft, I still find it hard to sit on for long periods of time. If you have a nice soft couch or chair, you may not need it, but if not either use a regular pillow or a ring cushion to avoid too much pressure.

    Squishy Stress Reliever Ball The other thing you can do is place two softballs just under your buttocks where your legs join your butt to elevate them a bit to relieve some pressure while sitting.


    Squatting Can Help if You’re Constipated

    The last thing most people think about when using the bathroom is position, but this can significantly impact the ease with which you eliminate and even increase your risk of bowel and pelvic problems, including constipation, hemorrhoids, and more. Most of you reading this probably sit to evacuate your bowel, but this requires you to apply additional force (straining), which has some unwanted biological effects, including a temporary disruption in cardiac flow.

    Sitting on a modern toilet is designed to place your knees at a 90-degree angle to your abdomen. However, the time-honored natural squat position (which is still used by the majority of the world’s population) places your knees much closer to your torso, and this position actually changes the spatial relationships of your intestinal organs and musculature, optimizing the forces involved in defecation.

    Squatting straightens your rectum, relaxes your puborectalis muscle, and allows for complete emptying of your cecum and appendix without straining, which prevents fecal stagnation and the accumulation of toxins in your intestinal tract. It is instructive that non-westernized societies, in which people squat, do not have the high prevalence of bowel disease seen in developed nations; in some cultures with traditional lifestyles, these diseases are uncommon or almost unknown.

    If you have trouble with bowel movements, especially constipation, I urge you to give the squat position a try. Squatting does involve strength and flexibility that adults tend to lose over time (but children have naturally). Special toilets and stools that get your body into a more “squatty” position can help you get closer to the ideal even if you’ve been sitting for decades.

    Food Allergies


    Another interesting perspective is that chronic anal fissures are related to food allergies. Here is some information I got from my doctor which I will share with you. If nothing is working and you want to try cutting back, another suggestion is to do the following. You should do this consistently for 12 weeks for it to be effective.


    Anal Skin Care

    The following instructions will help reduce or eliminate anal pain, soreness and itching. These instructions are directly from my Proctologist. If you use them, it will only work if you follow them exactly without any short cuts for 12 weeks.


    1. Take 1/2 teaspoon (only) per day of Metamucil or a similar product to start for one week and then increase to 1 teaspoon  per day. Metamucil is available without prescription at most pharmacies. Try to drink some extra water daily
    2. Eliminate the following items from your diet for at least 12 weeks
      • Coffee (including decaffeinated)
      • (you may have to taper gradually) in order to avoid headaches if you a heavy coffee drinker)
      • Tea (decaffeinated teas are permitted, avoid “mint” teas and green teas)
      • Chocolate 
      • Cola Beverages (Coke/Pepsi)
      • Alcohol – Of any kind
      • Citrus fruits and juices, especially grapefruits. Oranges, lemons, limes are not quite as bad
      • Avoid Grapes and grape juice. Do not take prune juice.
      • Apple and cranberry are ok
      • Chronic anal fissures and irritation are more common in summer as patients consume large amounts of seasonal fruits / berries / cherries etc. Please limit these items.
      • Milk, ice cream, yogurt. Cheeses seem less of a problem
      • Vitamin C tablets
    3. Do not use soap or a washcloth to clean the anal skin
    4. When wiping the anus after a bowel movement be extremely gentle.  No vigorous wiping
    5. keep tissue paper (Kleenex) in between the buttocks up against the anus and change it every few hours to keep the anal skin dry
    6. Avoid hot baths and showers. Take a lukewarm (5 minutes only) bath or shower daily.
    7. Wear 100% cotton underwear. Do not wear tight-fitting clothing


    Your symptoms will not resolve overnight. Be Patient. Two to three months may be required before symptoms resolve.




    Sphincterotomy (Surgery)

    This should be done as a last resort and all other alternatives should be tried. This is a painful procedure and not done without considerable thought. You will be in pain for a few days after the surgery.


    A Chronic Anal Fissure is a tear in the skin of the anus, usually caused when a large, hard stool overstretches the anal opening and damages the fragile skin. It is often associated with constipation, and less frequently, with chronic diarrhea, inflammatory bowel disease or sexually transmitted diseases (STDs) that involve the anus and rectum. Sometimes, the cause is unknown.

    Anal fissures can be acute or chronic. An acute fissure is a superficial tear and a short-term condition. A chronic anal fissure is deeper and may expose underlying muscle. When lifestyle and diet changes and medication fail, and the condition becomes chronic, surgery is recommended. A lateral internal sphincterotomy is a surgical procedure most commonly used to repair a fissure.

    Sphincterotomy Surgical Procedure

    A lateral internal sphincterotomy involves stretching or cutting the internal sphincter, the muscle that restricts and relaxes when stool passes from the body. Cutting the muscle prevents spasm and temporarily weakens the muscles, and this in turn helps the area to heal. The surgeon removes the chronic anal fissure and any underlying scar tissue.
    The surgery can be performed under local anesthesia, which involves injecting the immediate area with a numbing agent similar to that used at the dentist’s office, or spinal anesthesia, which numbs the entire lower body. In some cases, general anesthesia may be used, which renders the patient unconscious. The choice of anesthesia depends on patient and physician preference, the patient’s health, and the standard practice of the particular facility.Anal Fissure Header

    The patient is positioned on the table so that the anus and rectal area are exposed. This can be done face down, with the buttocks slightly elevated, or supine (on the back) with the legs held up in stirrups. After anesthesia is administered, the area is cleaned with an antiseptic solution.

    The operation takes about 20 to 30 minutes. The wound is then sutured closed, usually with stitches that dissolve in time. Most patients can go home the same day.

    Sphincterotomy Postoperative Complications

    The risk of complications from this procedure is very low, but they do develop occasionally. Most common are:

    • Excessive bleeding
    • Fecal incontinence, which is the loss of the ability to control bowel movements
    • Inability to urinate
    • Infection
    • Problems resulting from anesthesia
    • Risk of abscess or fistula

    Infographic Remedies for Colon Cleansing


    How to take a Sitz Bath?

    A sitz bath is one in which you sit in warm water to ease pain or swelling to the anus or vaginal opening. Your doctor might recommend a sitz bath to you if you’re suffering from hemorrhoids or chronic anal fissure, or if you’ve recently given vaginal birth that resulted in tissue damage. Regardless of which area needs treatment, drawing a sitz bath is an effective and soothing way to soothe the injury. Although there are specialized tools that you can use, you can just use your regular old bathtub. This article will tell you how to draw a sitz bath either way Carex Sitz Bath

    They are part and parcel of good health care. If taken regularly, circulation is stimulated, which in turn will benefit the abdominal organs and health in general.

    Sitz baths increase the blood circulation and eliminate congestions, stagnations, irritations and any initial stages of inflammation of the ovaries. Take them for hemorrhoids, urinary tract complaints, vaginal thrush, fibroids, pelvic congestion, painful menstruation and infection in the genital area. Regular sitz baths will have a great influence on your mental and emotional disposition and attitude. Medpro Sitz Bath

    A herbal sitz bath may speed up your body’s natural healing process. A sitz bath is a small tub that fits over your toilet and allows you to sit in warm water up to your hips. You can buy a sitz bath at your local medical supply store or from here. Fill the sitz bath three-fourths of the way with warm water. Add the ingredients listed below and soak for 20 minutes. If you choose to use your bathtub instead of a sitz bath, you can double or triple the recipe. Herbal baths can help you relax, speed up healing and help with hemorrhoids.

    Here are the ingredients you will need for your herbal sitz bath:

    • 1/2 cup Epsom salt
    • 2 tablespoons baking soda
    • 2 tablespoons witch hazel
    • 1 tablespoon olive oil
    • 8 drops lavender essential oil
    • 8 drops chamomile essential oil


    Check this site for additional Sitz Bath Recipe’s.

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    Thank you


    About the Author Steven

    Steven blogs for Healthy Fixation and blogs regularly on various blogs and health and fitness topics. Steven provides personal advice in specific areas he has experience with and his main goal is to help and assist people with health or personal challenges.

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