Version July 2025
Please read the Disclaimer at the end of this page.
What are discharge instructions? —
Discharge instructions are information about how to take care of yourself after getting medical care in the emergency department ("ED").
What should I know? —
You came to the ED because of pain while having a bowel movement. The doctors found you have an anal fissure, which is a tear in the lining of the anus. You might bleed during bowel movements, or have itching or irritation around your anus.
Anal fissures are often caused by constipation (when bowel movements are too hard, too small, hard to get out, or happening fewer than 3 times a week). To help your fissure heal and avoid getting another fissure in the future, try to avoid getting constipated (see below).
The doctor might have given you cream to put on your fissure. If so, use it exactly as instructed. It is important to finish all the medicine, even if you start to feel better. Some ointments used to treat anal fissures can cause a headache. Tell your doctor if this happens.
How do I care for myself at home? —
Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.
You should also do the following:
●Call your regular doctor and tell them you were in the ED. Make a follow-up appointment if you were told to.
●Take sitz baths to help relax the muscles around your anus and soothe irritation – Soak your buttocks in 2 or 3 inches of warm water for 10 to 15 minutes, 2 or 3 times a day. Do not add soap, bubble bath, or anything else to the water. It will probably help to take a sitz bath right after a bowel movement, but you can also do it anytime to ease pain.
●If you are bleeding during bowel movements, use wet wipes instead of toilet paper.
●To avoid getting constipation:
•Eat foods that have a lot of fiber. Good choices are fruits, vegetables, prune juice, and cereal.
•Take fiber supplements. If these aren't helping enough, you can take a stool softener. An example is docusate (sample brand name: Colace).
•Drink plenty of water and other fluids each day.
•Set a regular schedule to try and have a bowel movement. Do not ignore the urge to go.
•Try having a bowel movement first thing in the morning or soon after a meal.
•When you are trying to have a bowel movement, certain positions might help. Try leaning forward slightly and using a stool or foot rest under your feet.
•Take laxatives. These are medicines that help make bowel movements easier to get out. Some are pills you swallow. Others go into your rectum.
•Get regular physical activity. Some people find this helps.
When should I get emergency help?
●Return to the ED if:
•You have sudden severe or constant belly pain.
•Your belly gets very hard or swollen.
•You have a fever of 102.2°F (39°C) or higher.
When should I call the doctor? —
Call for advice if:
●You have a fever of 100.4°F (38°C) or higher, or chills.
●Your bowel movements are black or tar colored.
●You have blood in your bowel movements.
●You feel very weak.
●You vomit a lot.
●You have hemorrhoids (swollen veins in the rectum).
●You have hard bowel movements for longer than 2 weeks as well as belly pain.
●You have new or worsening symptoms.
Patient education: Anal fissure (The Basics)
Patient education: Constipation in adults (The Basics)
Patient education: Constipation in children (The Basics)
Patient education: High-fiber diet (The Basics)
Patient education: How to use rectal medicines (The Basics)
Patient education: How to take a sitz bath (The Basics)
Patient education: Anal fissure (Beyond the Basics)
Patient education: Constipation in adults (Beyond the Basics)
Patient education: Constipation in infants and children (Beyond the Basics)
Patient education: High-fiber diet (Beyond the Basics)
