Jini's Gut Guide
What Is an Anal Fissure*
Rectal or anal fissures are tears or cracks in the tissue of the anus or rectal canal. Fissures are usually caused by constipation and/or trauma, such as straining to pass too large or hard a stool, childbirth, or chronic diarrhea - all of which stretch, tear or irritate the mucosal tissue in the rectum or anus. A fissure tear can be minor and shallow, or go right down to the sphincter muscle.
Fissures occur in people of all ages, from infants to seniors. The first signs that you have a rectal or anal fissure may be painful bowel movements, and/or bright red blood on the toilet paper or in the toilet. Fissures may itch, and some have a bad-smelling discharge. The inflammatory bowel condition Crohn’s disease is a common cause of fissures. Hemorrhoids (also called piles) are often associated with fissures.
A mild anal fissure will usually heal on its own with no additional help, but deeper tears can become chronic unless you assist the damaged tissue to restore itself.
Natural Treatment For an Anal Fissure*
Let me start by giving you a few easy (low cost) remedies you can try first to heal your anal fissure. If they don't work well enough, then you'll likely need my custom-made FissureHeal suppositories. But as these are handmade by a compound pharmacy, they are not cheap! So you may want to try the other remedies first and see if that does the job. I invented FissureHeal because I had a severe anal fissure - since the birth of my son, two years earlier - that I was desperate to heal.
Onto the rectal fissure and anal fissure remedies...
Fresh Aloe Vera
You can use an aloe vera plant to make yourself rectal suppositories. Cut off a piece of the leaf, then cut away the green leaf and inside yellowish layer (it’s bitter and astringent), leaving only the clear inside meat of the plant. Insert this fresh aloe vera (cut to the desired length and width) into your rectum and leave it there until your next bowel movement, when it will come out naturally. You may need to wrap the cut aloe vera in cellophane and freeze it first to make it firmer and easier to insert.
If you insert this suppository before bed, then the aloe vera has all night (hopefully) to work its healing action. Re-apply after every bowel movement. Aloe Barbedensis is a good species of aloe vera with proven healing action.
A good healing salve for anal and/or rectal fissures is one made primarily from the comfrey plant. Other good ingredients to look for include plantain, aloe vera and vitamin E, but they must be together with the comfrey, because the comfrey is the premier would healer. Coat your finger well with the salve and insert into your rectum, massaging the salve into the tissue. Re-apply after every bowel movement, or as often as possible. Make sure you've washed your hands thoroughly before application and never stick the same, soiled finger back into your pot of salve.
As I mentioned, I created FissureHeal suppositories and have used them myself to heal both minor and severe anal fissures, and they work very well. They contain four of the most effective herbal mucosal healing agents known and we also use these ingredients in my Healing Implant Enema to help heal the lining of the small and large intestine when it is bleeding:
Slippery elm - good for diarrhea and ulcers when taken internally. Soothes inflamed mucous membranes of the stomach, intestines (rectum) and urinary tract.
Marshmallow root - soothes and heals mucous membranes, skin and other tissues. Aids the body in expelling excess mucus and fluid.
Comfrey root - speeds healing of wounds, bleeding tissues, and many skin conditions. Contains allantoin, a significant skin healer and regenerator.
Cocoa butter - a rich and soothing emollient to moisturize tissue, leaving it more supple and pliable.
Beeswax - only a minimal amount is added to increase stability and aid dispersion of the ingredients as the suppository melts. Beeswax is an emollient and protects rectal and anal tissue.
I've heard from readers who've had fissures for 5 to 6 years, and nothing else worked until they tried FissureHeal. A friend of mine's father had anal fissures as a result of his colon cancer treatment and he said the fissures were worse than the cancer! Needless to say, he was thrilled when FissureHeal got rid of this problem for him.
I made the suppositories very thin – as thin as a regular-sized drinking straw - so no matter how sore your anus and/or rectum are, they will insert easily. They're also extra long (2 inches) so they can reach a rectal fissure high up in your rectal canal – or you can break them off at the length you need. Insert them at night - or whenever you're likely to have your longest stretch without a bowel movement - so your rectum or anus has the maximum amount of time to heal undisturbed.
Apply Before & After Bowel Movements
Regardless of which remedy you use, the best times to apply it are before a bowel movement - so it can lubricate tissue and help it to stretch, while also preventing further damage. AND after your bowel movement. Clean your anal area with plain Kleenex and warm/hot water (no wipes - which leave an irritating chemical residue). Layer 2 tissues and fold them in half, then in half again to form a square. Flash this square under hot water and use it to clean gently around your anus. Feel free to use a washcloth (or the hot moistened Kleenex) as a hot compress for a few minutes - this is also soothing and healing. Then apply your chosen fissure remedy again.
If you're using FissureHeal (or you've made your own healing suppositories) you may only need a small length if your fissure is right at the opening of your anus - in that case, hold the suppository in place while it melts. Note: Anything pushed past the first anal sphincter muscle will be sucked up into the rectal canal, so if your fissure is near the opening, don't push the suppository in too far. You want to keep the remedy where the wound is. If your fissure is higher up, then use a longer length (break suppository to desired length).
It's also a very good idea to apply the remedy before you go to bed, so the tissue has a good length of time (undisturbed) to heal.
Make Your Own Suppositories
You can also make your own suppositories by adding any of the healing ingredients given above to a base of cocoa butter. You can either melt and pour them into molds, or use a hand-rolling method. Here's how:
Preventing Recurrence of Fissures
Once you've healed your anal fissures - or, to give them the best chance to heal - it's good to use a stool softening and bulking agent so that you don't have to strain or push too hard to have a bowel movement. I used to recommend MetaCleanse but the manufacturer has stopped producing it so, in its place, you can use 1 tbsp. sprouted flax and chia powder along with 1/2 tsp. bentonite clay. NOTE: You cannot use these remedies if you are on an exclusively elemental diet – only if you are combining Absorb Plus with regular foods. If you suffer from chronic constipation, then there are many contributing factors and I really encourage your to get my book, Listen To Your Colon to heal the underlying causes of constipation. At the very least, see my video to help make bowel movements easier:
If your fissure is the result of too many bowel movements (diarrhea) then see the Diarrhea symptom page on this site for complete instructions and why the flax/chia seed powder + bentonite clay combo is a great formula for you too.
Pregnancy, Breastfeeding, Babies: I have used aloe vera, comfrey and FissureHeal while pregnant and breastfeeding. I used FissureHeal suppositories on my daughter for a few days when she was six months old, and have used comfrey with all my children when necessary since infancy. The FDA strictly warns against comfrey for internal use because ONE woman died - who was very ill with multiple health conditions, taking all kinds of substances, but she also drank a lot of comfrey tea each day. However, although SEVEN THOUSAND people die each year from normal Aspirin usage, the FDA is happy for us to take Aspirin. Hmmmm....
SYMPTOM TREATMENT SUMMARY - RECTAL FISSURES
- If you get the FissureHeal suppositories, that's likely all you'll need to heal even deep rectal or anal fissures. Use at night, right before bed, and before/after bowel movements during the day, as needed. Follow insertion directions on the package.
- Otherwise, try the other fissure remedies (aloe vera and comfrey) if you wish.
- Take sprouted flax and chia powder with bentonite clay ongoing to keep stool soft and formed, to prevent recurrence of fissures.