People who develop anal fissures, which are tears in the skin that lines the anus known as anoderm, typically experience several common symptoms. Though fissures may be painless, most people experience some amount of pain from the condition, and it usually gets worse during a bowel movement. Another of the common fissure symptoms is itching and irritation around the anus. Often the patient will notice blood or discharge from the anus. In some cases, the fissure itself may be visible on the outside of the anus, and a lump or tag of skin may develop along the fissure.
Pain is the most common of the anal fissure symptoms, which the majority of patients have to some degree. Usually the pain of a fissure will increase significantly when the patient has a bowel movement. He or she might have the sensation that there is tearing or ripping within the anal canal, or it may sting or burn. The pain may be intense and may take anywhere from minutes to hours to subside.
For certain patients, the pain may still be present but significantly less between bowel movements, while for others it might subside completely. They may also find that the pain increases when they urinate. Some patients may develop constipation if the pain is so severe that they avoid moving their bowels.
Itching and irritation are also frequently anal fissure symptoms. The skin around the anus often becomes sensitive and sore, and can cause discomfort if it is touched. It may also develop an ongoing itch, a condition known as pruritus ani.
In many cases, one of the anal fissure symptoms a patient will have is bleeding. Though the amount of blood is typically minimal, it is often bright red and very noticeable on toilet paper or in the stool. Patients who have any anal bleeding should notify their doctor right away. In addition to blood, pus may seep from the tear, so some patients may also notice a foul-smelling discharge from the anus.
While some anal fissures are completely internal and may not be readily visible, it is often possible to see the tear crack in the skin around the outside of the anus. Patients may be able to see or feel lumps around the fissure. Sometimes a small tag of skin, known as a sentinal pile, can form near the end of the fissure as well.