Yes, anal fissures (and related itching/pain) often feel worse at night due to increased itching (pruritus ani) from moisture, heat, sweating, anxiety, or even unconscious scratching during sleep, which damages the skin and creates a cycle of irritation, making it harder to sleep and heal. Factors like diet, tight clothing, or underlying issues like threadworms can exacerbate these nighttime symptoms.
Certain factors raise the risk for anal fissures, including: Constipation with straining to pass hard stool. Eating a low-fiber diet. Intense diarrhea.
Anal fissures are small tears that occur when the tissue lining the anus is stretched too far. They can occur in people of all ages, and they are often mistaken for hemorrhoids.
Medicated creams can treat inflammation and pain. Take a sitz bath two or three times a day for at least 10-15 minutes. This is a shallow, warm water bath that you sit in to soak your anus. It can relieve your symptoms and help relax your muscles.
But itching provides no relief and may make your symptom worse. And any extra pressure on the area, like when you're sitting, may exacerbate your discomfort. It's also not unusual for this type of itchiness to increase after a bowel movement or at night when you're trying to sleep.
The longer food waste sits in your large intestine, the harder it gets to pass. Pooping is painful when you have an anal fissure, but not pooping exacerbates the condition. Adding fiber and fluids to soften your stool makes passing easier, potentially causing less pain.
The main treatments for anal fissures are:
Many anal fissures heal on their own. However, it's important to visit your doctor when you see blood in your stool or experience pain around your anus.
In the final stage of fissure healing, epithelialization and maturation occur. Epithelial cells migrate and cover the wound, forming a new layer of skin.
Most patients with anal fissures experience severe pain during and after bowel movements. These patients often describe that their bowel movements feel like “shards of glass” or “razor blades” when evacuating. This pain can last for several minutes to several hours after bowel movements due to anal spasm.
Sometimes, a colonoscopy procedure is used to look for the presence of an underlying condition that may be causing an anal fissure, such as irritable bowel syndrome (IBS). This is similar to an anoscopy and sigmoidoscopy, but which also examines the entire colon. Read about Preparing for a Colonoscopy ».
Most anal fissures heal in a few days or weeks with home treatment. But if a fissure lasts more than 8 to 12 weeks, you may need prescription medicines. These may include cream or gel vasodilator medicines or botulinum toxin (Botox) injections. In rare cases, surgery may be needed.
If someone has a chronic fissure, it is thought that the reason it has not healed is that the ring muscle (sphincter) that goes around the anus (back passage) has become so tense that the flow of blood to the lining of the anus is reduced.
Common causes of an anal fissure include constipation and straining or passing hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements.
One of these is to avoid spicy foods, which may cause burning in the cut area when you're passing a stool and make symptoms worse. It's also a good idea to avoid constipating foods, which can put added pressure on the anal canal and make it harder for the fissure to heal.
Critical Don'ts to Avoid Further Complications
Vitamin deficiencies – can lead to dry and itchy skin which if left untreated might end up in manifestation of skin fissures. A healthy skin needs a good number of proteins and vitamins like Vitamin B, C, A, E, D and K and minerals like zinc and essential fatty acids like omega fatty acids.
Sitting for 5 hr or more per day (exposure) was associated with an increased risk of developing hemorrhoids and/or anal fissures [odds ratio 3.68, 95% CI: 2.1–6.47]. Conclusion: The study showed that sitting down for 5 hr or more per day might increase the risk of developing hemorrhoids and/or anal fissures.
When the process of healing starts, the pain will reduce in both its severity and the number of times it occurs. It is possible to feel that constipation is less painful and that the stinging or burning feeling decreases as the day progresses. It is usually one of the earliest signs that the rift is beginning to close.
Healing tissue may occasionally itch, but this should not be as intense or persistent as when the fissure was at its worst. If you find yourself feeling more comfortable and less irritated throughout the day, it's a good sign that the fissure is healing.
Anal Fissures Symptoms to Look Out For:
A piece of skin that may hang out. You could feel it when you put your finger towards the inner part of your anus or the rim of your anus. A lump that appears bloody.
Reoccurring Fissures: If the fissure heals but keeps coming back, a more developed treatment might be necessary. Severe Pain: If the pain becomes unbearable and nonsurgical treatments aren't providing relief, laser surgery might be the best option.