If you suffer from an inflammatory bowel disease, such as Crohn's disease, you may be at increased risk for developing a small tear in the lining of the anus called a fissure, often caused by the passage of hard, dry bowel movements, diarrhea or inflammation. Anal fissures can also be caused by the overuse of laxatives and injury to the anal area during childbirth. Anal fistulas-also more prevalent in Crohn's sufferers-are abnormal narrow tunnel-like infected passageways or channels that are the result of a drained anal abscess. The infected fistula channel usually runs from the rectum to an opening in the skin around the anus, but in women with Crohn's disease or injuries due to childbirth, the fistula could develop in the vagina or bladder.

While fissures can cause sharp or burning pain during and following a bowel movement, infected fistulas are usually not painful or are only mildly painful. Other symptoms for anal fissures include:

  • Mild rectal bleeding following a bowel movement

Symptoms for fistulas include:

  • Persistent drainage of blood, pus or mucus from the anus
  • Recurrent anal abscesses

Treatment for Fissures

Fifty percent of the time, all fissures heal either on their own, usually within two to four weeks, or with non-surgical treatment, including:

  • Stool softeners to help reduce pain during bowel movements
  • Antibiotics
  • Medicated creams to clear up the infection
  • Sitz baths-soaking in plain warm water for 15 to 20 minutes-to relieve discomfort

If fissures don't respond to topical treatment, it may be necessary to correct the problem with minor surgery that is usually done on an outpatient basis.

Treatment for Fistulas

Treatment for anal fistulas can vary depending on whether Crohn's disease is involved. If it is, the problem can often be cleared up with a course of antibiotics or other medications. In some cases, antibiotics may also be effective in treating fistulas even if Crohn's disease is not involved, although in that case surgery is often an effective remedy.

Preventing Fissures and Fistulas

Having regular bowel movements and avoiding constipation are a good way to prevent anal fissures. Your best bet: Try softening your stool by gradually adding more fiber to your diet and by drinking six to eight glasses of water every day. To decrease your risk for developing both fissures and fistulas:

  • Keep the anal area dry by changing your underwear frequently and using talcum powder to absorb moisture
  • Clean the anal area gently