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Anal tears are small cuts or rips in the skin of your anus. Your anus is the opening from which stools (feces) come out. A tear here makes passing stools very painful.

If you have an anal tear (also called anal fissure), the pain after passing stools can last for hours after you've been to the bathroom.¹

Doctors don't know why some people get anal tears and others don't. There are a number of reasons why you may get an anal tear.^{1 2 3}

• Passing hard and dry stools. These types of stools can cause your anus to stretch and tear slightly because the skin around your anus is quite thin
• Constipation. When you're constipated, passing stools is difficult and you don't pass them often enough. This may lead to tears in your anus. But we don't know for sure how many people get tears because of constipation.
• Diarrhea may also cause tears in some people.

Most anal tears happen at the back of the anus. But 1 in 4 women and 1 in 12 men get a tear at the front.¹

It's unusual to have more than one tear at a time, or for the skin on the sides of the anus to tear. If this happens, your doctor may do some tests to see if the tears are due to an infection or a problem with your digestion.⁴

Anal tears often heal on their own. Or you may need to take some simple steps to help them heal. To learn more, see What can I do to help my anal tear heal?

Sometimes a tear stays open for several weeks or more. Tears that don't heal, or come and go for months, are called chronic anal tears.^{1 3} Your doctor will probably say your anal tear is chronic if you've had it for at least four weeks.³

Doctors think that some tears don't heal because the muscle that controls the anus tightens up (goes into spasm). The tightness can cause more pain, and it stops blood from getting to your anus properly. This prevents the tear from healing.^{2 5 6}

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.