Anal Fissure: Why Passing Stool Hurts So Much — and How to Fix It
An anal fissure is a small tear in the skin lining the back passage. It is one of the most common causes of severe pain when passing stool — a pain patients often describe as “passing broken glass” or “a knife cutting.” Although it is very painful, an anal fissure is not dangerous and the great majority heal with simple measures. For stubborn cases, modern painless laser treatment offers a quick, effective cure. This guide explains what causes a fissure, the warning signs, and the safe treatment available in Lahore.
What Is an Anal Fissure?
An anal fissure is a small crack or tear in the delicate lining of the anal canal (the back passage). It most often occurs after passing a hard or large stool, which stretches and splits the skin. The tear then triggers a spasm of the ring muscle around the anus, which reduces blood flow to the area — and this is why the fissure struggles to heal and the pain keeps returning.
The Pain-Constipation Vicious Cycle
A fissure sets up a cycle that keeps it going:
- A hard stool tears the lining
- The pain causes the muscle to tighten (spasm), cutting blood supply
- Because it hurts so much, the person avoids going to the toilet
- Holding it in makes the stool harder — which tears the fissure again
Breaking this cycle — by softening the stool and relaxing the muscle — is the key to healing.
Symptoms of an Anal Fissure
- Sharp, severe pain during and after passing stool — often lasting minutes to hours afterwards
- Bright red blood on the stool or toilet paper
- A visible small tear or skin tag near the anus
- Itching or irritation around the back passage
- Constipation — because the person fears the pain of passing stool
Fissures can affect anyone, from infants to the elderly. A fissure in an unusual position or with atypical features should be checked to rule out other causes.
Prevention & Simple Self-Care
Most fissures — especially recent ones — heal with these simple steps, which also prevent them coming back:
- Eat plenty of fibre (vegetables, fruit, whole grains) to keep stools soft
- Drink plenty of water
- Use stool softeners if needed, and avoid straining
- Take warm sitz baths (sitting in warm water) to relax the muscle and ease pain
- Do not delay going to the toilet when you feel the urge
Treatment: From Ointments to Painless Laser
1. Simple measures and medicines (first step). Along with the diet and bath measures above, doctors use special ointments that relax the ring muscle and restore blood flow, helping the fissure heal. These cure most fissures without any procedure.
2. Painless laser treatment (modern option). For chronic fissures that do not heal with medicines, laser treatment is an excellent, minimally invasive solution. It gently relieves the muscle spasm and promotes healing, with:
- Minimal pain and no large cuts
- Day-case treatment — home the same day
- Fast recovery and a quick return to normal life
- Care taken to protect the continence muscles
Traditional surgery (lateral internal sphincterotomy) remains a highly effective option in experienced hands. Your surgeon will recommend the safest, most suitable treatment for you.
When to See a Surgeon in Lahore
See a surgeon if the pain is severe, keeps coming back, or does not settle with simple measures within a few weeks, or if there is ongoing bleeding — which should always be checked. Prof. Dr. Zahid Mahmood is a General, Laparoscopic & Laser Surgeon in Lahore with over 30 years of experience in the modern, painless treatment of anal fissures and other anorectal conditions, in complete privacy and comfort.
👉 Book a confidential consultation today, or call 0300-4130159.
Frequently Asked Questions About Anal Fissure
Will an anal fissure heal on its own?
Many recent (acute) fissures heal within a few weeks with a high-fibre diet, more water, warm baths and healing ointments. Chronic fissures that keep returning usually need a procedure such as laser treatment for a lasting cure.
Why is the pain so severe for such a small tear?
The anal area is very sensitive, and the tear triggers a strong muscle spasm. This spasm is what causes the intense, lasting pain — and why relaxing the muscle is central to treatment.
Is anal fissure the same as piles?
No. Piles usually cause painless bleeding, while a fissure causes sharp pain when passing stool. They are different conditions, so a proper examination is needed to be sure.
Is laser treatment for fissure painful?
No. It is done under anaesthesia so you feel nothing during it, and because it is minimally invasive, discomfort afterwards is usually mild and settles quickly.
How can I stop fissures coming back?
Keep your stools soft and regular with a high-fibre diet and plenty of water, avoid straining, and do not delay going to the toilet. These habits are the best long-term protection.
Medically reviewed by Prof. Dr. Zahid Mahmood (MBBS, FCPS), General, Laparoscopic & Laser Surgeon, Lahore. This article is for general public awareness and education. It is not a substitute for a personal medical consultation. Please see a qualified surgeon for advice about your own condition.