Fissures are cracks in the skin or ulcers that form on mucous membranes. Fistulas are small fissures. In medical parlance these are most commonly referred to when painful, and occasionally bleeding lesions occur around the area of the anus.

Fissures and fistulas are most often caused by trauma. This may be from the outside, as in anal intercourse, or caused by passing hard stools, often associated with straining as in constipation. This latter tendency often associates fissures with haemorrhoids.

There are certain conditions such as Crohn’s disease that can have an association with anal fissures and therefore a persisting irritation or discomfort should be .investigated. Fissures and fistulas can occur at any age although adulthood is the most common time. Any such injury in a child, however, must sadly bring to mind the possibility of abuse, which must be addressed immediately.


Consider the probable cause and avoid the trauma.

If persistently constipated, see Constipation.

Application of Arnica, Calendula or Hamamelis ointments should clear the problem.

Consider the homeopathic remedies Aesculus, Ratanhia, Paeonia and Graphites.

If the problem does not relieve itself within a few days then consult a doctor, who needs to rule out any underlying condition. Surgical intervention, specifically anal dilation, which causes the small tear to open and thereby be healed more aggressively, may be required.