What to expect from a GP consultation for anal fissure

Describe when the pain starts, how long it lasts after passing stool, and whether blood is bright red or mixed through the stool. Your GP may ask about constipation, diarrhoea, pregnancy, previous fissures and bowel habits. They may gently inspect the skin around the anus. A digital rectal examination is not always needed when pain is severe, and your clinician should explain any examination beforehand. The assessment also considers haemorrhoids, infection and other causes of bleeding.

Your plan may include drinking enough fluid, gradually increasing fibre if suitable, avoiding straining and keeping stools soft. Warm baths can ease spasm and discomfort for some people. Use prescribed cream exactly as directed and report troublesome effects. Do not ignore ongoing constipation or repeatedly delay bowel movements, because hard stool can reopen the tear. A symptom diary can help show whether pain and bleeding are improving.

Seek urgent help for heavy or persistent bleeding, black stools, faintness, severe abdominal pain, fever or pus near the anus. Arrange review if pain is worsening, bleeding continues, the fissure keeps returning or treatment does not help. A change in bowel habit or unexplained weight loss also needs medical assessment rather than being attributed to a fissure.

Ask how to keep stools soft, how to apply any cream, and when improvement should be reviewed. Ask whether the appearance is typical of an anal fissure and what would lead to referral or another investigation.