Digestive Health Part 10: Anal Fissures, Fistulas & Leaky Gut

Digestive Health Part 10: Anal Fissures, Fistulas & Leaky Gut

Written by Dr. Claire Arcidiacono, ND leaky gut

For further questions or concerns email me at [email protected]

This week’s topic is a combination of things very distinct topics that all fit together. An anal fissure is a tear or cut in the skin of the anal canal. They usually start at the opening and extends into the anal canal. They can be deep into the tissue or superficial. (1) An anal fistula is where an abnormal connection between the anal canal and the perianal skin forms.  In other words, the two separate parts develop a “roadway ” that connects them so that unknowns unable to travel between the two unique body parts suddenly can. While usually anal fissures and fistulas are separate conditions, fistulas can be caused by chronic fissures. (2)


Anal fissures usually heal on their own, however, in some cases they can become infected and lead to chronic conditions such as ulcers or even fistulas. Fissures can be caused by both constipation and diarrhea, even if there is a large hard stool that has been passed. Any chronic medical issue that decreases blood flow, the area can also cause anal fissures to develop. Inflammatory bowel disease (both Ulcerative colitis and Crohns) can also lead to anal fissures. Other common causes include AIDS, syphilis, Herpes, chlamydia, HPV, certain cancers such as leukemia, anal sex as well as childbirth can also lead to anal fissures. Poor toilet habits is a common cause in young children. (3) Anal fistulas are common in individuals with a history of anal abscesses, chronic fissures, inflammatory conditions such as both forms of IBD, certain cancer therapies such as radiation therapy, and chronic diarrhea can also increase risk of anal fistula. (4)

The symptoms of anal fissures include bleeding and pain after a bowel movement. (5) Signs of an anal fistula also include bleeding and pain after a bowel movement, redness, soreness or itching of the skin near the anus, pus draining from around the anus, fever and chills as well as just not feeling well. (6) In order to diagnose both fissures and fistulas, it is important to see a GI doctor for a physical exam and possibly tests for example an anoscope or even an ultrasound.

What is Leaky Gut?

Leaky gut fits in this topic because of what it is. Fissures and fistulas can be thought of as different degrees of severe cuts in the intestines. Leaky gut, while not as severe as a tear or cut is similar in that the gut lining, which is supposed to be a solid wall, is impaired in some way allowing toxins and other things that should be kept separate to actually get into the body. Instead of being a solid bowl, your intestines are like a strainer letting things escape that shouldn’t. (7)  While it is not known exactly what causes leaky gut, there are known risk factors. For example, Celiac disease is a very common risk factor, with other risk factors include both forms of IBD and IBS, food allergies/sensitivities, pathogens such as “bad” bacteria/fungus or even parasites. Unlike fissures and fistulas, leaky gut doesn’t usually cause blood in the stool. In fact leaky gut in general tends to have very non-specific symptoms that can vary from person to person. Common gastrointestinal symptoms of leaky gut can include gas, bloating as well both diarrhea, constipation, nausea and vomiting. Leaky gut is also very closely related to different auto immune conditions. It is currently unknown if the autoimmune disease comes first or the leaky gut, but that’s a chicken or egg kind of question. Health starts in the gut so if someone with leaky gut does have an autoimmune disease, it is important to start with the gut health first! The most common autoimmune issues that have been found to be related to leaky gut include diabetes, multiple sclerosis, chronic fatigue syndrome, fibromyalgia, arthritis, asthma, acne, allergies and even different thyroid conditions! The best way to rule out leaky gut syndrome is to see a holistic doctor such as a Naturopath or a nutritionist! (8)

For Anal fistulas: If bleeding continues for more than six weeks, you may need to get corrective surgery. Otherwise, studies show that increasing water and sitz baths can be helpful to treat fissures. (9)

Suggestions that have been found in studies to help anal fissures, fistulas and leaky gut include eliminating any constipation or diarrhea, reducing stress and eliminating any food allergies. L-Glutamine has been found in studies to promote healing in the digestive tract. (10) Invite’s G.I. Maintain and L-Glutamine can promote healing in the digestive tract. Demulcent herbs have been found to be helpful in lowering inflammation in the digestive tract as well as reducing the incidence of opportunistic infection. These demulcent herbs can include the following: DGL, Aloe Vera, Slippery Elm and Marshmallow root. (11) Invite’s G.I. Maintain, Min Acid and DGL have the same effects as demulcent herbs. Colostrum has been found to reduce inflammation in the colon as well as help to increase the integrity of the lining of the digestive tract (12) Invite’s Colostrum and Neuroimmune can support the lining of the digestive tract. Zinc Carnosine has been found to lower the amount of gastric inflammation and injury making it very helpful for both IBD and IBS. (13) Invite’s GI Rebuild contains Zinc Carnosine and can support the digestive tract. Nucleotides while not usually a supplement with associate with the gut has been found in studies to be very helpful in working with any sort of wound healing. (14) Invite’s Nucleotide Complex is a great product to support your digestive tract.

Next week we will be talking about acid reflux, Ulcers, Gastritis and just “too much acid.”


  1. Gott, M. D.; Peter, H. (5 March 1998). “New Therapy Coming for Anal Fissures”. The Fresno Bee. Fresno, CA: McClatchy Co. p. E2, “Life” section A
  2. norectal Fistula”. Merck Manual Consumer Version. Retrieved 2016-06-27.
  3. “Anal Fissure – Causes”. NHS Choices. Archived from the original on 4 February 2013.
  4. https://www.karger.com/Article/Pdf/172039
  5. https://www.webmd.com/digestive-disorders/anal-fissure-treatment
  6. Mappes, H. J.; Farthmann, E. H. (2001-01-01). Anal abscess and fistula. Zuckschwerdt.
  7. https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451
  8. https://my.clevelandclinic.org/health/diseases/22724-leaky-gut-syndrome#symptoms-and-causes
  9. https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/anal-fistula.html
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369670/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065514/
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228205/#:~:text=Bovine%20colostrum%20has%20shown%20some,43%2C44%2C45%5D.
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856764/
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146642/

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