Signs an Anal Fissure is Healing: A Complete Recovery Guide
Key points
- Less pain during bowel movements: The sharp, cutting sensation will gradually become less intense.
- Shorter duration of post-BM pain: The throbbing, spasming pain that can last for hours after a bowel movement will diminish and eventually disappear.
- Greater overall comfort: You'll no longer be constantly aware of the discomfort while sitting or moving.
An anal fissure is a small but often intensely painful tear in the lining of the anus. The sharp pain during bowel movements, often described as passing glass, followed by hours of throbbing discomfort, can significantly impact your quality of life. Fortunately, most fissures can heal with proper care. Recognizing the signs of recovery is a crucial and reassuring part of the journey.
This comprehensive guide synthesizes information from medical experts and patient experiences to help you understand the signs of healing, navigate the recovery timeline, and learn how to prevent future occurrences.
Key Signs Your Anal Fissure is Healing
As your body begins to repair the tear, you will notice distinct changes in your symptoms. These are the most common and reliable indicators that you are on the path to recovery.
1. Reduced Pain and Discomfort
The most significant and welcome sign of healing is a decrease in pain. According to experts at GEM Hospitals, this is one of the most immediate signs of recovery. You'll notice:
- Less pain during bowel movements: The sharp, cutting sensation will gradually become less intense.
- Shorter duration of post-BM pain: The throbbing, spasming pain that can last for hours after a bowel movement will diminish and eventually disappear.
- Greater overall comfort: You'll no longer be constantly aware of the discomfort while sitting or moving.
2. Less Bleeding
As Medical News Today points out, a cessation of bleeding is a clear sign the wound is closing. You will see less bright red blood on the toilet paper or in the bowl. This indicates that new tissue is forming and the open tear is healing over.
3. Decreased Swelling and Irritation
Inflammation, redness, and swelling are common with an active fissure. As healing progresses, the area will look and feel less irritated and raw. If you developed a small, external skin tag (known as a sentinel pile), you might notice it begin to shrink.
4. Less Muscle Tightness and Spasms
Anal fissures often trigger spasms in the internal anal sphincter muscle, which can worsen pain and restrict blood flow, hindering the healing process. As the fissure heals, this muscle will begin to relax, leading to fewer and less intense spasms.
5. Itching Can Be a Good Sign (Sometimes)
Itching is a complex symptom. While it can be a sign of irritation from an active fissure, occasional, mild itching is also a normal part of the wound healing process as new skin forms. If the itching is accompanied by the other positive signs on this list, it's likely a part of your recovery.
6. Visible Wound Closure
For those who can self-examine, you may be able to see the physical evidence of healing. The tear itself will appear smaller as the edges of the tissue begin to knit back together.
An illustration showing the location of an anal fissure. Source: American Society of Colon and Rectal Surgeons (ASCRS)
Understanding the Healing Timeline: Acute vs. Chronic Fissures
Not all fissures heal at the same rate. The timeline depends on whether the fissure is acute (new) or chronic (long-lasting).
- Acute Fissures: These are tears that have been present for less than six weeks. According to the Cleveland Clinic, most acute fissures heal within a few days to weeks with consistent home care.
- Chronic Fissures: A fissure is considered chronic if it persists for more than six to eight weeks. These are often more difficult to heal because a cycle of pain, muscle spasm, and re-tearing has been established. Chronic fissures may require medical treatment to heal, which can take 6 to 12 weeks.
The Non-Linear Journey of Recovery: Why Healing Isn't a Straight Line
It's crucial to understand that healing is rarely a linear process. You may have several good days followed by a temporary setback, often triggered by a hard bowel movement. This fluctuation is normal and does not mean you have failed. The body's healing process occurs in distinct biological stages:
- Inflammation Phase: The body's initial response to injury, characterized by redness, swelling, and pain. This is a sign that the healing process has begun.
- Proliferation Phase: New tissue begins to form to fill the tear. Pain and swelling start to decrease during this stage.
- Maturation (Remodeling) Phase: The new tissue is strengthened and reorganized. You may still feel some tenderness or itching as the wound fully closes.
Embracing this non-linear path with patience and self-compassion is key to a positive recovery mindset.
How to Promote and Speed Up Fissure Healing
You can take several proactive steps to support your body's healing process and prevent re-injury.
Dietary and Lifestyle Adjustments
- Increase Fiber Intake: Aim for 25-35 grams of fiber per day from fruits, vegetables, and whole grains to soften stool. A fiber supplement like psyllium (Metamucil) or methylcellulose (Citrucel) can also help.
- Stay Hydrated: Drink plenty of water throughout the day to keep stools soft and easy to pass.
- Avoid Straining: Never strain during a bowel movement. If you feel the need, get up and walk around, then try again later.
Soothing Home Remedies
- Sitz Baths: Soaking the anal area in a few inches of plain warm water for 10-20 minutes, two to three times a day (especially after bowel movements), is highly effective. As noted in a Healthline article, this helps relax the anal sphincter muscle, reduces pain, and improves blood flow to promote healing.
Medical Treatments
If home care isn't enough, a doctor may recommend:
- Topical Ointments: Prescription creams like nitroglycerin or calcium channel blockers can help relax the anal muscles and increase blood flow.
- Botox Injections: Injections of botulinum toxin can temporarily paralyze the sphincter muscle, giving the fissure time to heal.
- Surgery: For persistent chronic fissures, a minor surgical procedure called a lateral internal sphincterotomy may be recommended.
When to See a Doctor
While most fissures heal with self-care, it is essential to consult a healthcare professional if:
- Your symptoms do not improve after 2-3 weeks of home treatment.
- The pain or bleeding worsens.
- The fissure becomes a recurring problem.
- You develop signs of infection, such as a fever or pus-like discharge.
A doctor can confirm the diagnosis, rule out other conditions, and provide a treatment plan to help your fissure heal for good.
References
- American Society of Colon and Rectal Surgeons. (n.d.). Anal Fissure Expanded Information. ASCRS. Retrieved from https://fascrs.org/patients/diseases-and-conditions/a-z/anal-fissure-expanded-information
- Cleveland Clinic. (2023, April 25). Anal Fissure. Retrieved from https://my.clevelandclinic.org/health/diseases/13177-anal-fissures
- GEM Hospitals. (n.d.). What Are the Signs That Your Fissure Is Healing? Retrieved from https://gemhospitals.com/blog/signs-fissure-healing
- Kassel, G. (2023, March 8). Itchy Anal Fissures: 10 Treatments and Tips. Healthline. Retrieved from https://www.healthline.com/health/anal-fissure-itchy
- Tee-Melegrito, R. A. (2023, February 10). The signs an fissure is healing and treatments. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/signs-a-fissure-is-healing
About the author
Fatima Al-Jamil, MD, MPH, is board-certified in gastroenterology and hepatology. She is an Assistant Professor of Medicine at a university in Michigan, with a clinical focus on inflammatory bowel disease (IBD) and motility disorders.