Specialty Surgical Associates

Anal Fissures and Fistulas

Anal fissures and anal fistulas are painful conditions that affect the tissue around the anus. While they may share some symptoms, they are very different problems — and each requires a specific treatment approach.

Our colorectal specialists provide comprehensive, discreet care for anal fissures and anal fistulas, offering both non-surgical management and advanced surgical solutions when needed. Our goal is to relieve pain, promote healing, and prevent recurrence.

Get Relief from Anal Pain

If you’re experiencing persistent anal pain, drainage, or bleeding, don’t delay care.
Call our office today or request an appointment online for a confidential consultation.

 

What Is an Anal Fissure?

An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools or chronic constipation.

Common Symptoms:

  • Sharp pain during bowel movements
  • Burning or lingering pain after bowel movements
  • Bright red blood on toilet paper
  • Visible tear near the anal opening

Most fissures heal with medication and dietary changes, but chronic fissures may require minor surgical treatment.

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What Is an Anal Fistula?

An anal fistula is an abnormal tunnel that forms between the inside of the anal canal and the skin around the anus, often following an abscess.

Common Symptoms:

  • Persistent drainage or pus
  • Recurrent anal abscess
  • Swelling or redness
  • Pain when sitting
  • Fever (if infection is present)

Fistulas typically require surgical treatment to fully resolve.

How to Prepare for Treatment

Preparation depends on whether you need medical therapy or surgery.

You may need to:

  1. Undergo a physical exam or imaging (such as MRI or ultrasound).
  2. Adjust certain medications.
  3. Fast after midnight if anesthesia is required.
  4. Arrange for transportation home after surgery.

We provide detailed instructions tailored to your condition and procedure.

Before the Procedure

  • Arrive early for check-in.
  • Bring ID, insurance card, and medication list.
  • Meet your surgeon and anesthesia provider (if applicable).
  • Review the procedure and ask any final questions.

We prioritize comfort, privacy, and clear communication.

During the Procedure

For Chronic Anal Fissures

A minor procedure called a lateral internal sphincterotomy may be performed to reduce muscle tension and promote healing.

  • Usually outpatient
  • Performed under anesthesia
  • Typically takes 15–30 minutes

For Anal Fistulas

Treatment may involve:

  • Fistulotomy (opening the tunnel to heal properly)
  • Seton placement (a small surgical thread to allow drainage)
  • Advanced flap procedures for complex fistulas

Procedures are usually outpatient and performed under anesthesia.

After the Procedure

Recovery varies depending on the procedure.

You may experience:

  • Mild to moderate soreness
  • Temporary drainage
  • Minor bleeding
  • Swelling

Most patients return to normal activities within a few days to weeks.

Contact your doctor immediately if you experience:

  • Fever
  • Increasing pain
  • Heavy bleeding
  • Persistent drainage with foul odor
  • Difficulty urinating

We provide clear post-procedure instructions and follow-up care.

Risks & Benefits

Benefits

  • Relief from chronic pain
  • Resolution of infection
  • Improved quality of life
  • Outpatient treatment options
  • High success rates

Risks

  • Bleeding
  • Infection
  • Recurrence
  • Rare changes in bowel control (depending on complexity)

Patient Resources & Education

We provide:

  • Dietary guidance for preventing constipation
  • Fiber and hydration recommendations
  • Post-procedure care instructions
  • Insurance and billing support
  • Online patient forms

Our team is here to answer your questions at every stage of treatment.

Frequently Asked Questions

Can an anal fissure heal on its own?

Yes, many acute fissures heal with medication and dietary changes. Chronic fissures may require minor surgery.

No. Most anal fistulas require surgical treatment to fully resolve.

Procedures are performed under anesthesia. Some temporary soreness during recovery is expected.

Recovery depends on the procedure but typically ranges from several days to a few weeks.

Recurrence is possible but less likely with proper treatment and follow-up care.

Don’t Live with Ongoing Discomfort

If you’re experiencing persistent anal pain or drainage, expert care can help.