Anal fissures can be unpleasant; there's really no other way to put it. They can cause burning, stinging, bleeding and itching that can decrease your quality of life, at least for a short while. The good news is that, if you have an anal fissure, diet changes can help bring you some relief.
The other good news is that most anal fissures heal on their own within six weeks and, once they're gone, you can make several dietary and lifestyle changes for anal fissure prevention.
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What Are Anal Fissures?
An anal fissure is a tear in the lining of the anal canal. Although they don't lead to more complicated issues, according to Michigan Medicine, anal fissures can be uncomfortable. Symptoms include burning, stinging, sharp pain during bowel movements, itching and bleeding.
Like anal fissures, hemorrhoids may be caused by too much pressure in the anal canal, but the two uncomfortable bowel conditions are different. You have a cluster of veins that lie right inside the mucus membranes in the lowest part of the rectum and anus. When these veins become swollen, they can cause discomfort, itching and bleeding; the condition most refer to as hemorrhoids.
Most anal fissures resolve on their own with little to no treatment in a few days to a few weeks. These types of anal fissures are classified as acute. In some cases, anal fissures can become chronic or recurring, lasting longer than 12 weeks and continually coming back.
What Causes Anal Fissures?
Anal fissures are caused by injury to the rectal canal from increased pressure. According to Michigan Medicine, your anal sphincter is under a certain amount of pressure all the time; however, if the pressure builds up too much, it can lead to reduced blood flow in the area and cause muscle spasms that tear the sphincter walls, causing a fissure.
The increased pressure and the resulting tears and injuries commonly happen when you're constipated and struggling to go to the bathroom or when you pass an abnormally large stool. Chronic diarrhea and childbirth can also cause an anal fissure.
According to Massarat Zutshi, MD, a colorectal surgeon at the Cleveland Clinic, changes in your bowel habits can put stress and pressure on your system and increase your risk of developing an anal fissure. There are some things you can do at home to alleviate or prevent a fissure, including following an appropriate anal fissure diet.
Avoid These Foods
You may not be able to completely prevent a fissure with diet alone, but you can do a few things to make yourself more comfortable while your fissure is healing. One of these is to avoid spicy foods, which can burn the cut area when you're passing a stool and make symptoms worse. If you have a fissure, foods to avoid include:
- Jalapeno, habanero, chipotle and any other hot peppers
- Buffalo sauce
- Hot sauce
- Cayenne pepper, chili powder and red pepper flakes
It's also a good idea to avoid constipating foods, like cheese, red meat, fast food, processed foods and frozen or pre-prepared foods, which can put added pressure on the anal canal and make it harder for the fissure to heal. Cedars-Sinai also recommends avoiding popcorn, nuts and tortilla chips.
Include These Foods
Although eating certain foods won't directly heal an anal fissure, you can reduce the pressure on your anal sphincter and promote natural healing by eating plenty of fiber, which softens stools and makes them easier to pass. The Mayo Clinic recommends getting 25 to 30 grams of fiber each day. Examples of high-fiber foods include:
- Wild rice and brown rice
- Green leafy vegetables (Swiss chard, spinach, beet greens, turnip greens, kale)
- Chia seeds
- Brussels sprouts
- Sweet potatoes
It's also helpful to drink a lot of water. Staying hydrated reduces your risk of constipation and helps prevent the straining that can cause anal fissures, so aim for at least eight glasses a day.
The Cleveland Clinic also recommends including some healthy fat and oils in your diet, like avocado, avocado oil, olive oil and grass-fed butter. Fats and oils help lubricate stools, making them easier to pass and reducing the pressure associated with constipation and the development of anal fissures.
Diet for Chronic Anal Fissures
If you experience anal fissures frequently, you might need to overhaul your diet more extensively. An April 2013 report in the American Journal of Gastroenterology found that a strict elimination-type diet called oligo-antigenic may be helpful, especially if chronic anal fissures occur as a result of constipation due to a food sensitivity.
For the study, researchers instructed people who had persistent anal fissures (or fissures that lasted more than six weeks) to follow a diet that excluded cow's milk (and any foods made from it, like cheese, yogurt or ice cream), wheat, egg, tomato and chocolate.
They chose these foods because of their connection to food sensitivity-induced constipation. After a period of four weeks on the diet, participants following the elimination diet experienced significantly more healing than participants following a control diet. Of the participants who healed, 20 percent had their anal fissures come back when they reintroduced milk or wheat to their diets.
Although there's little research on the subject, this study suggests that it may be beneficial to follow an elimination diet, or get tested, to uncover food sensitivities that may be the underlying cause of chronic or recurrent fissures. If you experience chronic fissures, find a doctor or nutritionist who has experience creating a diet plan for fissure patients.
Other Things You Can Do
In addition to revamping your diet, you can find some at-home relief for anal fissures by taking what's called a sitz bath. A sitz bath involves soaking several times a day in a warm (but not hot) bath that covers only your butt and hips.
According to the Cleveland Clinic, the pain that accompanies an anal fissure is generally caused by muscle spasms that occur following a bowel movement. The warm water from a sitz bath helps relax those muscles and can help alleviate symptoms, so you can find some relief while you're waiting for your fissure to heal.
- The American Journal of Gastroenterology: "Oligo-Antigenic Diet in the Treatment of Chronic Anal Fissures. Evidence for a Relationship Between Food Hypersensitivity and Anal Fissures"
- National Institutes of Diabetes and Digestive and Kidney Diseases: "Eating, Diet, & Nutrition for Constipation"
- Medline Plus: "High-Fiber Foods"
- Harvard Health Publishing: "Hemorrhoids and What to Do About Them"
- Cedars-Sinai: "Anal Fissures"
- Mayo Clinic: "Anal Fissure"
- Johns Hopkins Medicine: "Anal Fissures"
- UCSF Medical Center: "Anal Fissures"
- Cleveland Clinic: "How You Can Deal With Anal Fissures"
- Michigan Medicine: "Anal Fissure"
- MedlinePlus: "Sitz Bath"