What The Hole? Your No-BS Guide to Anal Fissures

Anal fissures aren't exactly dinner-party conversation, which means a lot of people end up alone with a painful problem, and a very specific search history.

We're here to change that.

If you've found yourself asking:

What do anal fissures feel like?
How to poop with an anal fissure?
Can anal fissures heal on their own?
Will an anal fissure heal on its own?
Is coconut oil good for an anal fissure?

You're in the right place. Let's take it from the bottom.

Understanding Anal Fissure Care

QUICK ANSWER: An anal fissure is a small tear in the mucosal lining of the anus. To promote healing and prevent further trauma: maintain soft stools, avoid straining during bowel movements, and take warm sitz baths.

Searching for fissure relief often brings up a frustrating truth: a very small tear can lead to significant daily pain. Lasting comfort requires a multi-step approach that minimizes friction and protects delicate skin as it heals naturally.

What Do Anal Fissures Feel Like?

What anal fissures feel like is often described as a sharp, cutting pain during a bowel movement, somewhere between a paper cut and a knife-like sting. Unfortunately, the pain doesn't always clock out when the bowel movement is over. It can linger as a dull ache or continue for hours afterward.

Other symptoms can include:

Burning or itching around the anus
Muscle spasms or tightening around the anal opening
A visible crack or tear
Bright red blood on toilet paper or stool

If you're wondering what an anus fissure looks like, an acute fissure may resemble a small crack or tear in the skin around the anus, similar to the look of a paper cut. A chronic fissure may be deeper and can sometimes be accompanied by a small skin tag or other tissue changes. Note: this is not a substitute for a doctor's diagnosis.

Do anal fissures bleed?

A small amount of bright red blood on the toilet paper or stool is a common symptom. That's also why fissures are often confused with hemorrhoids.

Hemorrhoids are swollen veins. An anal fissure is a tear.

How to Poop With an Anal Fissure

Knowing how to poop with an anal fissure comes down to one thing: working to make the bowel movement easier to pass without reopening the tear.

Don't Strain

Straining increases pressure and can reopen a healing fissure or create another tear. If nothing is happening, don't force it.

Get Your Position Right

A stool that brings your knees above your hips helps to get you into a more squat-like position on the toilet. The goal is comfort and reducing the urge to strain, find a position that allows you to relax rather than push.

Keep Stools Soft

Eating enough fiber and staying hydrated can help prevent constipation and keep stools softer and easier to pass. If you're increasing fibre, do it gradually, suddenly consuming an entire forest can cause bloating and gas.

Rethink the Wipe

Dry toilet paper can create additional friction on already irritated skin. Instead of aggressively wiping, try gentle dabbing and avoid scrubbing the area. Keeping the skin clean matters, but harsh soap and friction aren't doing sensitive skin any favours.

A gentle non-ionic cleanser can be part of a gentler cleansing routine for sensitive perianal skin.

How to relieve anal fissure pain often starts with reducing strain and friction. Keep stools soft, don't force a bowel movement, and consider a warm sitz bath afterward to help soothe the area.

Will an Anal Fissure Heal on Its Own?

The good news is that anal fissures can heal on their own. Because they're superficial tears, the healing time can be anywhere from a few days to several weeks.

Whether an anal fissure heals on its own often comes down to breaking the cycle of pain and re-tearing. The tear causes pain, which can cause the muscles around the anus to tighten and spasm, and those spasms may make it harder for the fissure to heal, sometimes turning a short-term problem into a chronic one.

While a simple fissure isn't typically associated with infection, symptoms like increased throbbing pain, fever, swelling, or discharge can mean something else is going on. If you're wondering whether an anal fissure can get infected, those symptoms warrant medical attention.

Home Remedies: Vaseline, Coconut Oil, and Daily Perianal Care

Vaseline and coconut oil are two of the most common recommendations you'll find when researching how to heal a fissure fast at home.

Both can help to keep the area moisturized and may make irritated skin feel more comfortable, but they're general-purpose occlusives, not formulas specifically designed for fissure-prone perianal skin.

Daily Care Spotlight: Hole Control® Duo

If you're prone to anal fissures, you already know how easily irritation and friction can make the area feel worse. Once you're addressing the underlying cause, a gentle daily routine can help avoid adding to the problem.

Hole Control® Duo is a doctor and OB/GYN co-developed, steroid-free two-step system made for sensitive, fissure-prone perianal skin.

Quick Fire: Your Questions Answered

Do anal fissures itch as they heal?

Itching can happen as the skin heals, but persistent itching may be caused by other irritations, moisture, or another skin condition.

Can an anal fissure bleed a lot?

Fissures typically cause a small amount of bright red blood on the toilet paper or stool. Heavy or persistent bleeding should be checked by a healthcare professional.

What causes anus fissures in the first place?

Anything that puts excessive strain or friction on the anal tissue can cause a tear. Common causes include hard stools, constipation, straining, chronic diarrhea, childbirth, and anal intercourse.

Sources

ASCRS: Anal Fissure Clinical Management Guidelines — American Society of Colon and Rectal Surgeons