An anal fissure is a small tear at the edge of the anus, very common and benign. Surgery is brief and resolves the pain in the vast majority of cases. You will go home the same day, and recovery is usually quick.
Before surgery
FastingNo solids for 6 hours before; clear fluids up to 2 hours before.
MedicationTell us if you take blood thinners or antiplatelets: you will receive instructions to stop them safely.
Bowel habitIn the days beforehand, plenty of water and fibre so you arrive without constipation and with soft stools.
PreparationBowel preparation is usually not needed. If indicated, an enema will be given that morning.
CompanionYou will need someone to take you home and cannot drive that day.
The day of surgery
AnaesthesiaUsually spinal or general, sometimes with local anaesthesia. The anaesthetist will assess this.
TechniqueDepending on the case: relaxing part of the muscle (sphincterotomy) or treating the fissure directly. Your surgeon will explain the option.
DurationUsually between 15 and 30 minutes.
Before dischargeYou must pass urine normally before going home.
After surgery
PainIt usually improves considerably compared with the fissure pain. Take your painkillers on schedule for the first days.
Sitz bathsWarm water 2–3 times a day and after every bowel movement: they soothe and help healing.
Avoiding constipationEssential: plenty of water, fibre and your prescribed laxative. Soft stools protect the area while it heals.
HygieneKeep the area clean and dry. No alcohol wipes or harsh soaps.
ActivityWalk from day one. Return to work is usually within a few days, depending on your job.
⚠ When to seek help immediately
Go to the emergency department or contact your team if you have:
Fever of 38 °C (100.4 °F) or higher
Pain that does not improve with your prescribed medication
Persistent vomiting or inability to keep fluids down
A wound that is red, warm, oozing or opening up
Difficulty breathing or chest pain
No gas or bowel movements together with abdominal bloating
Heavy bleeding that does not stop
Inability to pass urine within 8–12 h after surgery
