Is This Anal Fissure? Symptoms and When to Seek Help

Could this be an anal fissure?

I occasionally noticed blood on the toilet paper when wiping after using the restroom, and there was some pain on the outer skin of the anus with a small amount of blood at specific points.
Two days ago, I experienced abdominal pain that felt somewhat like diarrhea (though prior to that, my stools were relatively hard).
I initially felt the urge to have a bowel movement but delayed going for about an hour.
When I finally went, I had a large bowel movement, and upon wiping, I found the first piece of toilet paper was bright red with blood, and subsequent pieces had progressively less blood.
There was also a small amount of blood floating in the toilet water.
Could this be an anal fissure? Should I seek medical attention?

Niming, 20~29 year old female. Ask Date: 2017/08/01

Dr. Chen Jiaming reply Surgery

It is not possible to diagnose an anal fissure solely based on the presence of blood during anal wiping; a clinical examination by a physician is necessary.
Additionally, the severity of anal fissures can vary, and there are differences between acute and chronic cases, which affects treatment options.
Conservative management may begin with reducing friction from wiping; one could try using a cleansing method or switching to moist wipes.
Furthermore, improving bowel habits to prevent hard stools by increasing water intake and other measures is advisable.
If severe anal pain occurs, it is essential to seek formal evaluation and treatment promptly.

Reply Date: 2017/08/01

More Info

Based on your description, it sounds like you may be experiencing symptoms consistent with an anal fissure. An anal fissure is a small tear in the lining of the anus, which can occur due to various reasons, including passing hard or large stools, constipation, or straining during bowel movements. The symptoms you mentioned, such as the presence of bright red blood on toilet paper and in the toilet bowl, along with pain during bowel movements, are common indicators of this condition.

When you notice blood in your stool or on toilet paper, it can be alarming, and it's essential to pay attention to the accompanying symptoms. In the case of an anal fissure, the blood is usually bright red, indicating that it is fresh and likely coming from the anal area rather than from higher up in the gastrointestinal tract. The pain you described, especially if it occurs during or after bowel movements, further supports the possibility of an anal fissure.

Here are some additional points to consider regarding anal fissures and when to seek medical help:
1. Symptoms: Common symptoms of an anal fissure include sharp pain during bowel movements, a visible tear or crack in the skin around the anus, and bleeding. The pain can be severe and may last for several hours after a bowel movement.

2. Causes: Anal fissures can be caused by various factors, including:
- Passing hard or large stools
- Chronic constipation or diarrhea
- Straining during bowel movements
- Anal intercourse
- Childbirth
3. Self-Care Measures: If you suspect you have an anal fissure, there are several self-care measures you can take to alleviate symptoms:
- Increase Fiber Intake: Eating a diet high in fiber can help soften stools and make bowel movements easier.

- Stay Hydrated: Drinking plenty of water can help prevent constipation.

- Warm Baths: Soaking in a warm bath can help relax the anal muscles and relieve pain.

- Topical Treatments: Over-the-counter creams or ointments may help soothe the area and promote healing.

4. When to Seek Medical Help: While many anal fissures can heal on their own with conservative treatment, you should seek medical attention if:
- The bleeding persists or worsens.

- You experience severe pain that does not improve with self-care measures.

- You notice any signs of infection, such as fever or increased redness and swelling around the anus.

- You have recurrent fissures or if this is your first experience with anal pain and bleeding.

5. Medical Evaluation: A healthcare provider can perform a physical examination to confirm the diagnosis of an anal fissure and rule out other potential causes of rectal bleeding, such as hemorrhoids or more serious conditions. They may recommend treatments such as prescription medications, topical anesthetics, or in some cases, surgical options if the fissure does not heal with conservative measures.

In conclusion, based on your symptoms, it is advisable to consult a healthcare professional for a proper evaluation and management plan. Early intervention can help alleviate discomfort and prevent complications. Don't hesitate to seek help; your health is important, and addressing these symptoms promptly can lead to better outcomes.

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