Anal Fissure

Anal fissures are small tears found in the mucosa, which is the thin, moist tissue lining the anus. While anal fissures are common among infants, they can happen at any age, and they are the result of passing hard and/or large stools. They can also be caused by childbirth, anal intercourse, chronic diarrhea, or straining to pass a bowel movement as a result of constipation. Inflammatory bowel conditions like Crohn’s disease can also make a person more susceptible to anal fissures.

Applicable Procedures

Flexible Sigmoidoscopy

Are anal fissures serious?

Anal fissures typically get better on their own with relatively simple measures, like increasing the amount of fiber in your diet or taking a stiz bath. Some people may need medications to manage anal fissures, and less commonly, surgery may be necessary. If an anal fissure does not heal within 8 weeks, it is considered chronic and may require more formal treatment, especially if the tear extends to the internal anal sphincter, which is the muscle that holds the anus closed.

Which treatments or medications are typically used if treatment is needed for anal fissures?

A doctor may recommend nitroglycerin applied externally to relax the anal sphincter and increase blood floor in order to heal the anal fissure. Blood pressure medications and Botox injections can also be used to relax the anal sphincter as treatment for anal fissures. Doctors may recommend the use of topical agents like lidocaine to relieve pain. If your anal fissure is severe or does not respond to less invasive treaments, a doctor may perform a surgery called a lateral internal sphincterotomy, which involves removing a small part of the anal sphincter muscle.

Are there ways to prevent anal fissures?

Having one anal fissure increases your risk of experiencing another in the future, but there are steps you can take to prevent recurring fissures. Taking a fiber supplement and increasing the amount of high-fiber foods, such as fruits, vegetables, whole grains, and beans, in your diet can soften your stool and reduce your risk of anal fissures. The ultimate goal is to eat 25-30 grams of fiber per day, but you may need to gradually increase fiber in your diet to prevent bloating. Drinking enough water, which prevents constipation, and avoiding straining during bowel movements, which can cause a tear, are also preventive measures for anal fissures.

Common Symptoms

  • “I suddenly began to experience pain during bowel movements, and I noticed I was bleeding afterward.”
  • “After wiping, I saw fresh, bright red blood on the toilet paper, and I was in pain for several hours.”
  • “I felt a small bump near my anus, as well as a small crack in the skin around that area.”

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What Our Patients Are Saying

I’ve been a patient of Dr. Weber for almost a decade. My husband for more than & it was he who recommended Dr. Weber. He’s knowledgeable & well experienced in his field. Plus he’s an all around kind & nice guy. And you’d like how the office & tech staff are trained to run the operation of this practice. Efficient, patient and helpful! I’d feel very comfortable recommending this practice.

Vicki M.

I had a great time. Everyone was very friendly and professional. One nurse said I had nice eyes, which really helped my self esteem. Dr. Willie was fantastic. His concern about having magenta ink for the printer really shows what a caring man he is. The pictures turned out great. I framed them and hung them up on my wall at home. But, seriously the experience was pleasant. Thank you to everyone involved.

Terry M.

Lord knows having a colonoscopy is zero fun. The prep nearly did me in. But after arriving at suite 270 every single person was pleasant and efficient. The attention to cleanliness in the office is very apparent and appreciated. Every employee introduced themselves by name, apologized for an IV that took two tries and made sure I was as comfortable as can be before I was ready to leave. However, I’m going to enjoy every minute of the five years before I need to return!

Marie C.

I have been here several times and have always been treated great. The receptionist are so kind and the nurses are wonderful so is the anesthesia person are so kind and answers any concerns you might have. My Dr Bologna is awesome. This is the place to go if you need endoscopy or colonoscopy. Thank all the staff for being so kind

Debbie A.

Our Doctors

We’re proud of our team here at Digestive Health Institute. Our health care providers include some of the very best colorectal surgeons, gastroenterologists and physician assistants. To learn more about our qualified team of specialists, please visit our providers page.

Anezi E. Bakken MD, MS

Sante D. Bologna MD, FACP

M. Emin Donat MD, FRCPC

Freeha Khan MD

Partha S. Nandi

Leonard G. Quallich III MD

Jack Tocco DO

John R. Weber MD

Richard T. Wille MD


What happens during my first visit?
If you are a new patient, you can expect to have a complete physical exam. You will also be asked detailed questions about your current problems and your past medical history, your current medications, allergies, your family history and other pertinent medical information. If you are taking medications, please bring a completed medical history form with you to your appointment. Once the physician has reviewed your medical information and completed the physical examination, a plan of care will be developed. You may need to be seen again in the office, be referred back to your family physician for follow-up care, or require additional testing. If additional tests are needed, we will assist you in scheduling these tests.
What if I need to schedule an endoscopic procedure?

An endoscopic procedure allows the physician to visualize a part of your gastrointestinal tract with a special instrument called an endoscope. If your family physician has ordered testing, you will be contacted by telephone by one of our staff members. If a physician orders testing and you are in the office, the procedure can generally be scheduled during the course of your visit. You will be given a date, time, and location for the test, as well as written instructions telling you how to prepare for the test. If you have any questions about the procedure, please feel free to ask one of our staff members or the physician.

How do I get test results?

We ask that you wait 10 to 14 days before contacting us for results. Often results come from several different sources. This information needs to be compiled and reviewed by your physician before you can be appropriately advised. 

What insurances do you accept?

We accept payment from most insurance companies including Medicare, Blue Cross/Blue Shield, Blue Care Network, Physicians Health Plan, Cofinity, Sparrow Professional Health Network, Medicaid, McLaren, Health Plus, and several others. Accepted insurances are subject to change at any time without notice.

If your insurance requires an authorization from your primary care physician, you may be asked to assist us in obtaining this authorization.

All patients are responsible for all copays and deductibles at the time of service.

If you have any questions regarding your benefits or insurance coverage, please contact our Billing Department at 248-844-9710.

What if I need to contact the doctor?

To contact your doctor during business hours please call our main number 248-844-9710. If you have an urgent need to speak with the doctor after hours, you will be rerouted to our after hours answering service, and your doctor will be paged. In the case of a medical emergency please proceed directly to the nearest hospital emergency room.

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