At a glance
It is the moment many people with a fissure dread most. You can feel it. It is hard. And you know what it might do.
- Do not force it. Straining is the thing most people say made it worse.
- Give it time, and help the muscle relax. Knees up, slow breaths out, warm water and walking around are the most common things people describe.
- The first part is often the hardest. It has been waiting the longest. Holding on, which is natural when it hurts, gives it more time to harden.
- Glycerin suppositories come up often. People describe using them with a pharmacist’s advice.
- If it will not come and you feel unwell, get help. That is not overreacting.
What people describe doing in the moment
These come up again and again across many anonymised accounts. They are what people try, not a set of instructions.
Not pushing. People describe sitting, breathing out slowly and letting the stool move on its own pace rather than bearing down. Straining raises pressure on the tear and can bring on spasm.
Raising the knees. A footstool under the feet, leaning forward a little, elbows on knees. Many people describe this as making the stool easier to pass with less effort. Some even describe squatting.
Using warm water to relax. A warm bath or sitz bath before trying, or a warm shower, is a very common move. People describe the warmth helping the muscle let go. Some use a bidet or shower spray on the outside of the area.
Getting up and walking. If it is not moving, people describe giving up for now, walking around the house for ten minutes or so, then coming back when the urge returns. Sitting and straining for a long time is something people regret.
A barrier on the outside. Some people describe applying petroleum jelly or a similar ointment to the skin around the anus before going, to reduce friction. This is outside only.
A drink and a little movement. A warm drink or a glass of water, then some gentle movement, is something people say helps things shift.
Glycerin suppositories. These come up often for a stool that feels stuck low down. People describe using them with a pharmacist’s advice. They are not right for everyone, and inserting anything can hurt with an active fissure. Ask a pharmacist first. Our glycerin suppositories guide has more on what people report.
When nothing works. If a stool will not pass despite all of the above, that is the point to call a pharmacist, NHS 111 or your GP the same day rather than keep trying. Some people describe trying to remove stool by hand; this can tear delicate tissue, make a fissure worse, and is not something to attempt on your own.
Why the first part is often hard
A very common pattern is a hard first piece followed by softer stool. People call it a “hard tip” or a “plug”.
The bowel keeps drawing water out of stool for as long as it sits there. The part that reaches the rectum first waits the longest, so it ends up driest and firmest.
Fear makes this worse. When going hurts, people hold on. Holding on gives the stool more time to dry out. Then it hurts more. Many people describe getting stuck in this loop.
Some people also wonder whether sphincter spasm plays a part, holding stool back until it hardens. Some describe the hard tip going away after treatment that relaxed the sphincter. That is a question worth raising with a clinician.
“Why does a hard one sometimes hurt less?”
This surprises people. Most advice is about keeping stools soft, yet some people find a firm, formed stool more comfortable than a loose one.
Reasons people give:
- Loose stools mean more trips, so more wiping and more contact with a sore area
- Watery stool can sting a healing tear
- Very loose stools can leave you feeling unfinished, so you go again and again
- Some people also have haemorrhoids or IBS that react badly to loose stools
So the goal is not “as soft as possible”. Most people describe aiming for soft and formed. That might look like type 4 on the Bristol stool chart. Too hard tears. Too loose irritates.
Preventing the next one
What people describe doing to avoid the moment altogether:
- Going when the urge comes, rather than waiting until later
- Drinking earlier in the day. Some people found they were drinking plenty, but only from the afternoon onwards
- Keeping softening steady, rather than only reacting after a hard day
- Watching fibre type, since some fibres soften while others mainly add bulk
- A routine, such as a warm drink and some time on the toilet at the same time each day
- Not stopping a softener suddenly once things feel better, a common cause of a hard stool weeks later
- Keeping a simple record of stools, food and flare-ups to spot what tends to come before a hard one
If you are doing all of this and still getting hard stools, talk to your GP or pharmacist. There may be other options, or another reason for it.
When to seek care
Get urgent help (call 999 in the UK, or your local emergency number) if you have:
- Heavy bleeding that will not stop, or you feel faint
- Severe tummy pain, a swollen tummy or vomiting, especially if you cannot pass stool or wind
See your GP or call NHS 111 the same day if you have:
- A stool that is stuck and will not pass despite trying
- Watery leakage around a stool that will not come out, which can be a sign of a blockage
- Fever, swelling, a hard painful lump or discharge near the anus
- Pain that is getting worse rather than better
- You have had recent anal surgery and cannot pass stool; contact your surgical team or NHS 111
- Bleeding alongside unexplained weight loss, ongoing tiredness, or a family history of bowel cancer. Do not wait for a routine slot; say this when you book.
Book a GP appointment if:
- Hard stools keep happening despite changes to diet and softeners
- Your fissure has not healed after six to eight weeks
- Your bowel habit has changed and stayed changed. This matters at any age, and more so over 50