Anal Fissure Specialist

Karen Zaghiyan, MD, FACS, FASCRS

Colorectal Surgeon located in Los Angeles, CA

Anal fissure is a common problem affecting men and women of all ages — even babies. As a double board-certified proctologist at her practice in Los Angeles, California, Karen Zaghiyan, MD, FACS, FASCRS, offers the latest colorectal treatments available for issues like anal fissure. If you have pain or bleeding with your bowel movements, call Karen Zaghiyan MD or schedule an appointment online today.

Anal Fissure

What is an anal fissure?

An anal fissure develops when you have a small tear in the skin at the opening of your anus. These tears can cause severe pain during and after a bowel movement that can last for a few minutes or hours.

When you have an anal fissure, it’s common to have rectal bleeding with a bowel movement that’s visible in the toilet bowl or on your tissue paper after wiping.

What causes an anal fissure?

Anal fissures generally occur because of trauma to your anal opening, most commonly after having a hard bowel movement. But you can also develop an anal fissure due to diarrhea.

Additional causes of anal fissures include:

  • Crohn’s disease
  • Infections
  • Tumors

Most anal fissures heal on their own, but if you have a chronic anal fissure lasting several weeks to a month, Dr. Zaghiyan might recommend medical treatment. 

How are anal fissures treated?

Dr. Zaghiyan often uses dietary management and medicine to manage anal fissures. This approach often includes:

  • Increasing your fiber intake by eating more bran, fresh fruits, and vegetables
  • Adding fiber supplements to your diet
  • Drinking more water
  • Taking 10-20 minute warm baths, known as “sitz baths,” three times per day
  • Using prescription ointments that relax your anal sphincter and promote healing

For chronic fissures that persist despite a trial of medical treatments, Dr. Zaghiyan might recommend a procedure or surgery.

Why would I need anal fissure surgery?

If you have a tight anal sphincter, you can be prone to having a non-healing anal fissure that’s more difficult to treat, so Dr. Zaghiyan might suggest two different types of minimally invasive treatments. 


This anal fissure therapy uses botulinum toxin, commonly known as Botox, to relax your sphincter. During this procedure, Dr. Zaghiyan injects Botox into your internal sphincter muscle. This may be performed as an office procedure or under anesthesia depending on the nature of your condition. 

Anal fissure surgery

During anal fissure surgery, Dr. Zaghiyan divides a portion of your internal anal sphincter to help the muscle relax so your fissure can heal. Dr. Zaghiyan often performs this procedure as an outpatient treatment so you can go home the same day.

Even after treating anal fissures through diet, medication, or surgery, they can still return after a hard bowel movement. It’s essential to continue staying well-hydrated and eating high-fiber foods to keep your stools soft and bulky to prevent anal fissures from recurring.

For more information on anal fissures, call Karen Zaghiyan MD or schedule an appointment online today.