Bowel Issues: Is It Anal Fissure and Menstrual Impact?

Bowel movement issues

Hello doctor, last week I had stomach discomfort and had to strain a lot while having a bowel movement, which caused pain in my anus.
However, there was no blood when I wiped.
After that, my anus hurts every time I have a bowel movement.
Could this be an anal fissure? Does menstruation have any impact on this? If I have my period, can I still see a colorectal specialist?

Ru Ru, 20~29 year old female. Ask Date: 2018/08/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
You may have an anal fissure.
Please visit for an examination.
Changhua Hospital cares about your health.
Chen Shidian.

Reply Date: 2018/08/26

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 that can occur due to passing hard or large stools, which can cause significant pain during and after bowel movements. The fact that you are experiencing pain during bowel movements, especially if you have to exert a lot of effort, aligns with this condition.
While you mentioned that there is no visible blood when wiping, it’s important to note that fissures can sometimes cause pain without visible bleeding, especially if they are small or healing. However, if you notice any blood in your stool or on the toilet paper, it is crucial to seek medical attention.
Regarding your question about menstruation, hormonal changes during your menstrual cycle can indeed affect bowel habits and may contribute to gastrointestinal discomfort. Some women experience increased bowel sensitivity or changes in bowel habits during their menstrual period due to hormonal fluctuations, which can lead to constipation or diarrhea. This can exacerbate existing conditions like anal fissures, as the straining associated with constipation can worsen the fissure and lead to more pain.

If you are currently menstruating, it is still advisable to see a colorectal specialist if your symptoms persist or worsen. Menstrual cycles should not prevent you from seeking medical care, especially if you are experiencing significant discomfort. A healthcare provider can offer appropriate treatment options, which may include dietary changes, topical medications to promote healing, and pain relief strategies.

In addition to seeking medical advice, here are some general recommendations to help manage your symptoms:
1. Increase Fiber Intake: Consuming a diet rich in fiber can help soften stools and make bowel movements easier. Foods like fruits, vegetables, whole grains, and legumes are excellent sources of fiber.

2. Stay Hydrated: Drinking plenty of water is essential for maintaining soft stools. Aim for at least 8-10 glasses of water a day.

3. Avoid Straining: When you feel the urge to have a bowel movement, try to go as soon as possible. Straining can worsen fissures and lead to further discomfort.

4. Warm Sitz Baths: Taking warm baths can help soothe the anal area and promote relaxation, which may alleviate some pain associated with fissures.

5. Topical Treatments: Over-the-counter creams or ointments containing hydrocortisone or other soothing agents can provide relief from pain and inflammation.

6. Consult a Specialist: If your symptoms do not improve with these measures, or if you experience severe pain, bleeding, or other concerning symptoms, it is essential to consult a colorectal specialist for a thorough evaluation and potential treatment options.

In summary, while your symptoms suggest the possibility of an anal fissure, it is crucial to consult a healthcare provider for an accurate diagnosis and appropriate treatment. Menstruation should not deter you from seeking medical care, and addressing your symptoms promptly can help prevent further complications.

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