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Surgery may be recommended in persistent cases of anal fissure where self-help measures and medicine have not helped. They can also tell you about self-help measures and treatments that can relieve your symptoms and reduce the risk of fissures coming back. The anal sphincter is the ring of muscles that open and close the anus. This may include a more thorough examination of your bottom carried out using anaesthetic to minimise pain. You can help soothe the pain by taking simple painkillers, such as paracetamol or ibuprofen , or by soaking your bottom in a warm bath several times a day, particularly after a bowel movement. Anal fissures are most commonly caused by damage to the lining of the anus or anal canal, the last part of the large intestine. Diagnosing anal fissures A GP will ask you about your symptoms and the type of pain you have been experiencing. In some people, symptoms from anal fissures last 6 weeks or more chronic anal fissures. A digital rectal examination , where a GP inserts a lubricated, gloved finger into your bottom to feel for abnormalities, is not usually used to diagnose anal fissures as it's likely to be painful.

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