What to Do When Your IBS Causes Anal Fissures

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Question: Due to my IBS, I tend to suffer from repeated anal fissures. What can I do?


Anal fissures are a common complaint of people who have IBS, particularly those who have constipation predominant IBS. The hard stools and straining associated with constipation are both possible contributors to the onset of anal fissures. The silver lining here is that anything you do to help your system to treat your IBS and get your system to function more regularly should also help to reduce your risk of a fissure.

What Are Anal Fissures?

Anal fissures are small tears in the lining of the opening of the anus. Anal fissures can be quite painful, particularly during a bowel movement. You may see signs of bleeding, either on the stool, on your toilet paper, or in the toilet.

Note: Any sign of blood associated with your bowel movements needs to be brought to the attention of your doctor as it can be the sign of a serious health problem. 

How to Prevent Anal Fissures?

The main recommendation for avoiding fissures is to keep the stool soft. Although this can be difficult to do with IBS, there are a couple of things that you can try:

  • Increase your fiber intake. Do this slowly as to allow your body time to adjust without exacerbating your symptoms.
  • Stay well hydrated so as to help to keep your stools soft.
  • Try not to strain during your bowel movements. Stay relaxed and let the process happen on its own.
  • Don't delay your bowel movements. Respect any urges from your body to eliminate and head for a bathroom, as opposed to holding it in until you get home.
  • Try using bowel retraining strategies as a way to try to establish a more regular schedule for bowel movements, thus encouraging more frequent, and therefore softer, stools.
  • Talk to your doctor about medication to keep your stools soft, such as Metamucil or Miralax

What to Do When You Have an Anal Fissure

1. Take a sitz baths, particularly after experiencing a bowel movement.

Sitz baths encourage the movement of blood in the area of your anus, which helps to promote healing. 

2. After bowel movements, clean your anus with cotton balls that have been soaked in warm water. You may have better results if you add a little salt to the water.

3. Talk to your doctor. Your doctor may recommend one or more of the following:

  • A suppository medication or a cream to reduce swelling and ease pain
  • A botox injection
  • A minor surgical procedure known as a lateral internal sphincterotomy


Madalinski, M. "Identifying the best therapy for chronic anal fissure" World Journal of Gastrointestinal Pharmacology and Therapeutics 2011 2:9-16.

Minocha, A. & Adamec, C. (2011) The Encyclopedia of the Digestive System and Digestive Disorders (2nd Ed.) New York:Facts on File.

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