Crohn's disease and anal fissures

Frequent diarrhoea, repeated straining and ongoing inflammation around the anus can irritate or split delicate skin. A fissure may then remain painful because each bowel movement stretches the area. Crohn's disease can also cause other perianal problems, including drainage or a tender swelling, which should not be assumed to be a simple fissure.

Tell the clinician where the pain is, whether it follows bowel movements, whether you see blood, and whether you have abdominal pain, diarrhoea, fever or discharge. A gentle examination may be enough to guide the next step; deeper or persistent symptoms may need specialist assessment.

Book a GP consultation if anal pain or bleeding persists, returns, or makes bowel movements difficult. Keep stools soft by drinking regularly and following individual dietary advice. Do not insert creams, suppositories or other products unless a clinician recommends them, especially if Crohn's disease is possible. Follow prescribed treatment and report worsening pain, drainage or a new lump.

Seek urgent help for severe anal or abdominal pain, fever with a painful swelling, pus or persistent drainage, heavy bleeding, faintness, repeated vomiting, or inability to pass stool or gas. Prompt review is also needed when diarrhoea is ongoing or you cannot maintain fluids. These features can indicate a complication or another condition requiring treatment.

Ask whether the findings fit a fissure, whether Crohn's disease could be contributing, and whether you need a blood test or another investigation. Ask which pain-relief and bowel-care products are suitable, how to recognise infection, and when follow-up should happen.