What Are the Risk Factors That Increase the Recurrence of Anal Fissure?

What Are the Risk Factors That Increase the Recurrence of Anal Fissure?
A fissure is a groove, natural division, deep furrow, crack or tear in the various parts of the body. An anal fissure is a crack or tear in the thin and moist tissue [mucosa] that lines the anus. Two types of anal fissures can be noticed: acute anal fissure and chronic anal fissure. Anal fissures can develop into anal ulcers [large open wounds] if left untreated or misdiagnosed.

What Are the Causes & Symptoms of An Anal Fissure?

Any individual regardless of age and gender can get affected by an anal fissure. A few of the causes of an anal fissure are chronic diarrhea, severe constipation, strain during bowel movements, poor cleaning habits after defecation, vaginal birth, anorectal cancer, anal sex or anal intercourse, inflammatory bowel diseases, and sexually transmitted diseases [STD’s] like HIV, herpes, and syphilis, etc.

If you are suffering from an anal fissure, you can notice one or many of the following symptoms.

  • Severe and sharp pain during and after bowel movements
  • Burning sensation in the anus
  • Itching in and around the anus
  • Leakage of pus from the anal region
  • Passing blood with stool
  • A visible crack or tear in the skin around the anus
  • A lump or skin tag near the location of anal fissure
If you have an acute anal fissure, it can be treated with medications, dietary changes, and lifestyle modifications. In case you are suffering from a chronic anal fissure, it can’t be treated with medications and should require a surgical intervention.

Factors That Increase the Risk of Recurrence of Anal Fissure:

Acute and chronic anal fissures can reoccur within a year after the surgery. Several factors can contribute to the recurrence of anal fissures, and a few of them are listed below.

  • Anal sex or anal intercourse:

Avoid having anal sex or anal intercourse until your doctor says it is safe. If you participate in anal sex or intercourse within a week after the surgery, you are at higher risk for recurring an anal fissure. Follow the instructions as suggested by your doctor to decrease the chances of recurrence of anal fissure.

  • Eating food items that contain less or poor fiber:

If you eat food items that contain less fiber, you can suffer from constipation and can increase strain during bowel movements that lead to anal fissures. So you are advised to eat foods that contain high fiber content like watermelons, sweet potatoes, bananas, brown rice, cabbage, strawberries, and cauliflower, etc.

  • The number of anal fissures:

If you are suffering from a single anal fissure then it is easy to treat and the chances of recurrence of anal fissure will be very low. In case of multiple fissures, treating all of them in a single surgery is complex and you can be at higher risk for recurring anal fissures even after the surgery.

  • Being overweight:

If you are obese or overweight, there is a chance for recurring anal fissure even after the surgical treatment. Being overweight can increase constipation and strain on the blood vessels in the anal region which leads to an increase in the formation of anal fissures.

  • Underlying disease:

If the anal fissure is caused as a secondary disease due to underlying disease like Crohn’s disease, then there is a higher chance for recurrence of anal fissure even after the surgery. In such cases, the primary disease should be treated on priority, and then anal fissure surgery should be performed to reduce the rate of recurrence of anal fissure.

  • Not drinking adequate water:

Drinking plenty of water [3-4 liters] can help in keeping your stools soft, avoids constipation, and decreases strain during bowel movements. If you are drinking adequate water, then you can face difficulty in passing stools as they become hard and cause constipation. This ultimately leads to increase strain in the blood vessels that are located in the anal region and increases the recurrence of anal fissures.

  • Medical conditions:

If you are suffering from medical conditions like diabetes or any blood disorders or diseases, you may experience a delay in your healing process as they can weaken your immune system after the anal fissure surgery. Before undergoing anal fissure surgery, discuss with your doctor or surgeon and tell him/her about your past and present medical history.

  • Previous anal fissure surgery:

If you have a history of anal fissure surgery then you are at higher risk to experience the recurrence of anal fissure and to suffer from its symptoms.

  • Drugs:

If you are using immunosuppressive medications and steroids, consult with your doctor whether to continue those medications or not. Because they can impair the healing process after an anal fissure surgery and result in persistence and recurrence of the fissures.

  • Lack of physical activity or exercise:

Perform the daily exercise for about 20-30 minutes to help in pushing the toxins and waste out of your body naturally. Exercise can help in building and maintaining muscles, including those that are present in your anal lining and intestinal tract. Exercises can help in reducing constipation and decrease the strain during bowel movements. Due to this, exercises can reduce the chance of anal fissure recurrence. If you fail to do daily exercise, then you are at a higher risk for recurrence of anal fissure.

  • Unhygienic wound care:

Hygenic and proper wound care is important in achieving a successful outcome of anal fissure surgery. Caring for the wound helps in promoting the healing process and reduces the occurrence of complications. If not following proper and hygienic wound care, you may end with a persistent or recurrent anal fissure.


An anal fissure can be treated with medications and surgery. However, in a few cases, there is a chance for recurrence of anal fissure due to the above-mentioned factors. Following all the instructions and suggestions from the doctor and maintaining hygienic wound care can help in decreasing the chances of recurrence of an anal fissure. In case you think you have a recurrence of anal fissure, contact your doctor immediately and get treated.

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