Constipation: Is It Hemorrhoids or Anal Fissures? - Gastroenterology and Hepatology

Q: Constipation: Is It Hemorrhoids or Anal Fissures?

Hello： It is recommended to consult a gastroenterologist or a colorectal specialist to help determine whether it is a hemorrhoid or an anal fissure. <br>Changhua Hospital cares about your health. <br>Dr. <br>Tsai An-Shun.

Currently facing a significant issue?

I have not had this issue before, but I have been experiencing frequent constipation.
A few days ago, during a bowel movement, the first stool was very large and hard, and it felt like my anus was being stretched.
Afterward, there was some bleeding (around the anus and on the stool).
Initially, I thought it might be an anal fissure, but I didn't pay much attention to it.
However, in the past two days, I have experienced slight pain during bowel movements, along with bleeding (around the anus, with a brighter red color).
Additionally, even though I haven't had a bowel movement, there is a foul-smelling liquid around the anus mixed with some stool.
I'm unsure if I have hemorrhoids or an anal fissure, as I tend to sit for long periods.
I kindly request your advice.

Dùzi kùnrǎo shàonián, 20~29 year old female. Ask Date: 2016/08/24

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is recommended to consult a gastroenterologist or a colorectal specialist to help determine whether it is a hemorrhoid or an anal fissure.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2016/08/24

More Info

Constipation can often lead to discomfort and complications such as hemorrhoids or anal fissures, and understanding the differences between these conditions is crucial for effective treatment. Based on your description, it seems you are experiencing symptoms that could be associated with both hemorrhoids and anal fissures.

Hemorrhoids are swollen veins in the lower rectum and anus, similar to varicose veins. They can be internal or external. Symptoms of hemorrhoids include:
- Bright red blood on the toilet paper or in the toilet bowl after a bowel movement.

- Pain or discomfort, especially during bowel movements.

- Swelling or a lump near the anus.

- Itching or irritation in the anal region.

Anal fissures, on the other hand, are small tears in the lining of the anus. They are often caused by passing hard or large stools, which can stretch the anal canal and lead to tearing. Symptoms of anal fissures include:
- Sharp pain during and after bowel movements.

- Bright red blood on the stool or toilet paper.

- A visible tear or crack in the skin around the anus.

- Spasms of the anal sphincter muscle.

From your description, it seems that you have experienced hard stools leading to pain and bleeding, which is characteristic of both conditions. The presence of a foul-smelling liquid mixed with stool could indicate a few things, including possible infection or an issue with hygiene, especially if there is difficulty in cleaning the area due to pain.

Given that you have been experiencing these symptoms after a period of constipation, it is likely that the hard stools have caused either hemorrhoids or anal fissures, or potentially both. The fact that you mentioned sitting for long periods may also contribute to the development of hemorrhoids, as prolonged sitting can increase pressure in the rectal area.

Recommendations:
1. Dietary Changes: Increase your fiber intake through fruits, vegetables, whole grains, and legumes. Fiber helps to soften stools and promote regular bowel movements. Additionally, ensure you are drinking plenty of water to stay hydrated.

2. Over-the-Counter Treatments: Consider using stool softeners or laxatives if dietary changes are not sufficient. Topical treatments for hemorrhoids, such as creams or ointments, can help alleviate discomfort.

3. Warm Baths: Soaking in a warm bath can help soothe the anal area and promote healing if you have a fissure or hemorrhoids.

4. Avoid Straining: When you feel the urge to have a bowel movement, try not to delay it. Straining can worsen both hemorrhoids and fissures.

5. Consult a Healthcare Provider: Given the presence of blood and pain, it is essential to consult a healthcare provider for a proper diagnosis. They may perform a physical examination and possibly recommend further tests to determine the exact cause of your symptoms. They can also provide you with a tailored treatment plan based on your specific condition.

In conclusion, while both hemorrhoids and anal fissures can cause similar symptoms, the treatment and management strategies may differ. It is crucial to address these symptoms promptly to prevent further complications and improve your quality of life.

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