Anatomical illustration of an anal fissure with labeled views of the rectum, anus, and large intestine, including magnified close-up images showing the fissure within the anal canal.
An anal fissure is a small tear in the lining of the anus. It commonly causes sharp pain during bowel movements, burning, and bright red bleeding on the toilet paper or stool.
Anal fissures are very common and are often caused by trauma to the anal canal, especially from passing hard stools or repeated irritation. Many fissures improve with conservative treatment, but some become chronic and require medical or surgical management.
Dr. Aisha Akhtar, a board-certified colorectal surgeon in Phoenix, specializes in diagnosing and treating anal fissures and other conditions affecting the colon, rectum, and anus.
What Is an Anal Fissure?
An anal fissure is a split or tear in the thin tissue that lines the anal canal. The tear may expose the underlying muscle, which can lead to pain, spasm, and poor healing.
Anal fissures are often confused with hemorrhoids because both can cause rectal bleeding and discomfort, but they are different conditions and may require different treatment approaches.
Types of Anal Fissures
Anal fissures are generally classified as acute or chronic.
Acute Anal Fissure
An acute fissure is a new tear that has been present for a short time. These fissures often heal with non-surgical treatment.
Symptoms may include:
Sharp pain during bowel movements
Burning or stinging afterward
Small amounts of bright red bleeding
Fear of passing stool because of pain
Chronic Anal Fissure
A chronic fissure is one that does not heal and may remain present for several weeks or longer. Chronic fissures may develop scar tissue and are more likely to require procedural treatment.
Features of a chronic fissure may include:
Persistent pain with bowel movements
Recurrent tearing
Visible skin tag near the fissure
Exposed internal sphincter muscle
Ongoing bleeding or irritation
Common Symptoms of Anal Fissure
Symptoms of an anal fissure often include:
Sharp pain during bowel movements
Burning pain that may last after a bowel movement
Bright red blood on toilet paper or stool
A small tear near the anus
Spasm or tightness in the anal area
A small lump or skin tag near the fissure in chronic cases
Anal fissures usually develop when the anal lining is stretched or injured.
Common contributing factors include:
Constipation
Passing hard or large stools
Repeated straining
Chronic diarrhea
Childbirth
Anal trauma
Increased anal sphincter tone
Inflammatory bowel disease in some cases
The pain caused by a fissure can lead to muscle spasm, which may reduce blood flow and make healing more difficult.
Acute vs Chronic Anal Fissure
Type
Description
Acute fissure
New tear, often heals with medical treatment
Chronic fissure
Persistent tear that may develop scar tissue and require surgery
How Is an Anal Fissure Diagnosed?
Diagnosis usually involves a medical evaluation that may include:
Medical history review
Physical examination
Gentle inspection of the anal area
Additional testing if symptoms suggest another condition
In many cases, the fissure can be identified during examination. Further evaluation may be recommended if symptoms are atypical or if other anorectal conditions need to be ruled out.
These evaluations help distinguish anal fissures from:
Hemorrhoids
Anal abscess
Fistula
Crohn’s disease
Other causes of rectal bleeding
Treatment Options for Anal Fissure
Treatment depends on whether the fissure is acute or chronic and how severe the symptoms are.
Conservative Treatment
Many anal fissures improve with non-surgical care such as:
Increasing dietary fiber
Drinking more fluids
Stool softeners
Warm sitz baths
Avoiding straining
Avoiding prolonged sitting on the toilet
These measures help reduce trauma during bowel movements and support healing.
Medical Treatment
If symptoms persist, treatment may include prescription therapy aimed at reducing pain and relaxing the anal sphincter to improve blood flow and healing.
Medical treatment may include:
Topical medications
Pain control measures
Targeted treatment for constipation or diarrhea
Surgical Treatment
For chronic fissures or fissures that do not respond to medical therapy, procedural or surgical treatment may be recommended.
Treatment options may include:
Botulinum toxin injection
Lateral Internal Sphincterotomy
Surgical treatment is usually considered when symptoms are persistent, severe, or recurrent.
When Should You See a Doctor?
You should seek medical evaluation if you experience:
Severe pain with bowel movements
Persistent rectal bleeding
Symptoms lasting more than a few weeks
Recurrent tearing
A lump, drainage, or swelling near the anus
Changes in bowel habits
Symptoms that do not improve with home treatment
Rectal bleeding should always be evaluated to rule out other colorectal conditions.
“Dr. Akhtar and the entire team made what could have been a very stressful experience feel comfortable, reassuring, and genuinely cared for from...Dr. Akhtar and the entire team made what could have been a very stressful experience feel comfortable, reassuring, and genuinely cared for from start to finish. Dr. Akhtar was professional, compassionate, and took the time to thoroughly explain everything before my procedure, which immediately put me at ease. The procedure itself went smoothly, and I truly felt I was in excellent hands the entire time.The office staff was also kind, organized, and attentive throughout the process. I’m incredibly grateful for the level of care, patience, and professionalism I received. I would absolutely recommend Dr. Akhtar to anyone looking for a skilled doctor who truly cares about their patients and their comfort.”
Michelle Abby
★★★★★
“I cannot express the how thankful I am for Dr. Akhtar. I had been to 4 other colorectal doctors, 3 gastro doctors before seeing Dr. Akhtar. I was...I cannot express the how thankful I am for Dr. Akhtar. I had been to 4 other colorectal doctors, 3 gastro doctors before seeing Dr. Akhtar. I was crying in her office when she met me the first time. That didn't deter her. Not only that but she located the issue on my first visit. She is kind, caring, thorough and incredibly knowledgeable. She listens, spends time with you and doesn't talk over you. I've needed extra time to discuss my case many times and she has always taken the time that I needed. I've brought to her research I've read, and she always already knows about the publications. The staff are kind and helpful. I dont know what I would have done without finding her. Another health care provider recommended her highly as do I.”
Lorena Zeilman
★★★★★
“Best colorectal surgeon I’ve ever met. Dr. Akhtar is compassionate, gentle, warm, and caring. I came to her in Glendale after having a horrific...Best colorectal surgeon I’ve ever met. Dr. Akhtar is compassionate, gentle, warm, and caring. I came to her in Glendale after having a horrific experience with a general surgeon in Flagstaff (where I live). The Flagstaff surgeon caused a hemorrhage that almost cost me my life, and then I developed stenosis after the emergency room surgeon “fixed” the hemorrhage. Dr. Akhtar was kind enough to take me as a patient (most surgeons will not take a patient who has already been operated by another surgeon due to liability). She was very respectful and gentle in the examination, and was even able to fit me in for an outpatient procedure under sedation the very same day (knowing that I drove over 2 hours to see her). I could not be happier with her. She took the time to personally call me the next day to check on my progress. You do not see this type of doctor very often anymore. She is someone who is in it for the patient, and you can tell. I will continue to drive over 4 hours there and back to receive her high quality care and expertise. Cannot recommend her highly enough.”
Brianna Stabler
★★★★★
“Dr. Akhtar is THE BEST provider I have ever seen, period. She is incredibly knowledgeable, informative, and above all so kind. I have not met...Dr. Akhtar is THE BEST provider I have ever seen, period. She is incredibly knowledgeable, informative, and above all so kind. I have not met many people who have as comforting a bedside manner as she does. I was educated properly every step of the way and felt confident doing so because of her caring demeanor. Her PA Moses is also so friendly and upbeat, helping to ease any tension you may be feeling prior to the exam. The energy both Dr. Akhtar and Moses bring was paramount to how excellent my experience was here. Given their specialty, it would be easy to have an uncomfortable experience. However, they go the extra mile to make sure you are comfortable and reassured before anything is done. I cannot recommend this practice enough. Thank you Dr. Akhtar for the genuine concern and care you provided to me! Both my body and my outlook on my health outcomes are better off because of you.”
Huda Albayati
★★★★★
“Dr. Aisha Akhtar is an amazing and caring doctor. She helped me so much throughout my treatment and made me feel comfortable and supported every...Dr. Aisha Akhtar is an amazing and caring doctor. She helped me so much throughout my treatment and made me feel comfortable and supported every step of the way. She is very knowledgeable, patient, and truly listens to her patients. I’m very grateful for her care and highly recommend her to anyone looking for an excellent colorectal surgeon.”
Renee Wolf
★★★★★Jun 2, 2026
“The whole office was wonderful. Dr Akhtar was excellent. She was thorough. She explained things extremely well. She answered all my questions. I...The whole office was wonderful. Dr Akhtar was excellent. She was thorough. She explained things extremely well. She answered all my questions. I never felt like she was rushing my exam.”
Susan Denise
★★★★★May 29, 2026
“I have never met a Dr. As Brilliant, Kind and Compassionate as Dr. Ahktar! I even told her I wish she could be my primary physician. Just beyond...I have never met a Dr. As Brilliant, Kind and Compassionate as Dr. Ahktar! I even told her I wish she could be my primary physician. Just beyond lovely inside and out. I feel very blessed to be in her care!! There is no amount of stars that would be adequate enough to express how extraordinary she is!!!!”
Kathryn Hassett
★★★★★May 28, 2026
“Dr. Akhtar listens and cares about her patients, she is having new staff trained, please be patient. I have all the convenient she will ask help me.”
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Anonymous
★★★★★May 21, 2026
“Dr. Akhtar professionalism , knowledge, integrity and empathy are outstanding qualities! I could not have asked to be in the care of anyone...Dr. Akhtar professionalism , knowledge, integrity and empathy are outstanding qualities! I could not have asked to be in the care of anyone better than her. I highly recommended her!”
Michael Brown
★★★★★May 21, 2026
“Doctor Akhtar is very respectful and kind when dealing with difficult medical issues. I really appreciate her.”
