Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency care for:
Heavy bleeding or bleeding that will not stop
Fainting, confusion, severe weakness, or breathing difficulty
Black, tar-like stool
Severe illness with rapidly worsening rectal pain or swelling
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Contact a healthcare professional promptly for increasing pain, fever, swelling, pus, abdominal pain, persistent diarrhea, unexplained weight loss, a major change in bowel habits, or new difficulty controlling gas or stool.
These signs are not typical of a straightforward fissure and may require urgent testing or treatment.
3
Does any of this apply?
Book an appointment
Arrange follow-up if pain or bleeding continues, symptoms repeatedly return, treatment causes side effects, or you cannot keep stool soft.
Persistent symptoms may require confirmation of the diagnosis or treatment to relax the sphincter.
The article also says
An uncomplicated fissure may improve over days to weeks.
Continue the recommended bowel-care plan after pain decreases because hard stool can reopen the tear.
Every sign above is quoted from the sofidex article on Anal fissure. If you are not sure, err upward — it is always reasonable to be checked.