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Anal fissures can be caused by trauma to the anus and anal canal. The trauma can be caused by one or more of the following:

  • Chronic (long-term) constipation
  • Straining to have a bowel movement, especially if the stool is large, hard and/or dry
  • Prolonged diarrhea
  • Anal ***, anal stretching
  • Insertion of foreign objects into the anus

Causes other than trauma include:

  • Longstanding poor bowel habits
  • Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus)
  • Scarring in the anorectal area
  • An underlying medical problem, such as Crohn's disease and ulcerative colitis (types of inflammatory bowel disease); anal cancer; leukemia; infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia, chancroid, HIV)
  • Decreased blood flow to the anorectal area

Anal fissures are also common in young infants and in women after childbirth.

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