Post-Anal Fissure: Managing Diarrhea and Digestive Changes

Since the anal fissure, I have been experiencing frequent diarrhea?

Hello, Doctor.
I would like to ask a question.
About a month ago, I was busy with some matters and had to strain particularly hard during a bowel movement due to an urgent situation.
Later that evening, around 7 to 8 PM, I discovered blood in my underwear, which lasted for about 3 to 4 days.
During this time, I also experienced pain while having bowel movements, and there was blood on the stool, with slight blood staining in my underwear.
After that, there was no more blood, but I was still concerned, so I went to the hospital.
The doctor, after examining me with a gloved hand and inserting a lubricated finger into my rectum, diagnosed me with anal fissure.
He prescribed me an anal suppository and a stool softener.
After taking the medication for 1 to 2 days, I experienced almost no pain during bowel movements, and there was no more blood.
However, over the past month, my stools have been very thin or sometimes I have diarrhea.
Occasionally, after eating, I feel pain on the left side of my abdomen.
Previously, my stools were normal and thicker.
I am unsure if I should go to the hospital for further examination, as I exercise very little and spend about 6 hours a day sitting in front of the computer.

Lin Xiansheng, 10~19 year old female. Ask Date: 2017/08/02

Dr. Chen Qifeng reply Gastroenterology and Hepatology

1.
It is indeed a phenomenon of anal fissure.
2.
Even if there is a tumor, the narrowing would be gradual and not sudden.
This aspect should be related to impaired rectal function.

Reply Date: 2017/08/02

More Info

Post-anal fissure management, especially when accompanied by changes in bowel habits such as diarrhea or changes in stool consistency, can be a complex issue. It’s essential to understand the underlying causes and how to effectively manage your symptoms to promote healing and prevent recurrence.

Understanding Anal Fissures
An anal fissure is a small tear in the lining of the anus, often caused by passing hard stools or straining during bowel movements. Symptoms typically include sharp pain during and after bowel movements, as well as bleeding. The fact that you experienced blood in your underwear and pain during bowel movements indicates that your fissure was likely acute, which is common after straining.

Current Symptoms and Concerns
You mentioned that after the initial treatment with suppositories and stool softeners, the pain during bowel movements has subsided, and there is no longer blood present. However, you are now experiencing changes in your bowel habits, such as having thin stools or diarrhea, and occasional left-sided abdominal pain after eating. These symptoms could be related to several factors:
1. Dietary Changes: If your diet has changed due to stress or other factors, it could affect your bowel habits. A diet low in fiber can lead to constipation or thin stools, while high-fat or spicy foods can sometimes lead to diarrhea.

2. Hydration: Adequate hydration is crucial for maintaining healthy bowel movements. Dehydration can lead to harder stools, while excessive fluid intake, especially with certain foods, can lead to looser stools.

3. Physical Activity: A sedentary lifestyle, such as sitting for long periods, can contribute to digestive issues. Regular physical activity helps stimulate bowel function and can prevent constipation.

4. Stress and Anxiety: Stress can significantly impact your digestive system, leading to changes in bowel habits. The body’s response to stress can alter gut motility, resulting in diarrhea or changes in stool consistency.

Recommendations for Management
1. Dietary Adjustments: Aim for a high-fiber diet that includes fruits, vegetables, whole grains, and legumes. Fiber helps bulk up stool and can prevent straining during bowel movements. If you are experiencing diarrhea, consider a temporary low-fiber diet until your symptoms stabilize, then gradually reintroduce fiber.

2. Hydration: Drink plenty of water throughout the day. Staying hydrated can help maintain stool consistency and prevent constipation.

3. Regular Exercise: Incorporate physical activity into your daily routine. Even short walks can help stimulate bowel function and improve overall digestive health.

4. Monitor Symptoms: Keep track of your bowel habits, including frequency, consistency, and any associated pain. If you notice persistent changes, such as ongoing diarrhea or abdominal pain, it’s essential to consult a healthcare provider.

5. Follow-Up with Your Doctor: Given your history of anal fissures and current symptoms, it would be wise to schedule a follow-up appointment with your healthcare provider. They may recommend further evaluation, such as a colonoscopy, especially if you have persistent changes in bowel habits or abdominal pain.

6. Consider Stress Management Techniques: If stress is a contributing factor, consider practices such as mindfulness, yoga, or other relaxation techniques to help manage your stress levels.

Conclusion
In summary, while your initial treatment for the anal fissure seems to have been effective, the subsequent changes in your bowel habits warrant further attention. By making dietary adjustments, staying hydrated, increasing physical activity, and monitoring your symptoms, you can help manage your digestive health. However, do not hesitate to seek medical advice if your symptoms persist or worsen, as early intervention can prevent complications and promote healing.

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