Chronic Anal Fissures: Symptoms, Healing, and Concerns

Anal fissure pain, chronic anal fissure?

Hello Doctor: I have a chronic anal fissure issue.
Previously, I experienced bleeding during bowel movements.
On December 25 of last year, after visiting a hemorrhoid clinic, the doctor prescribed me an ointment to care for the wound, stating that it should improve.
Since that day, I have improved my lifestyle by drinking 2000cc of water daily, eating more fruits, avoiding spicy, fried, and grilled foods, and regularly taking warm sitz baths and applying the ointment.
As a result, I no longer have constipation and do not bleed during bowel movements; however, I still feel a slight stinging sensation at the wound site.

1.
Does this mean that the anal fissure has not fully healed, or has it improved significantly and can only get better to this extent? It does not affect my quality of life, but I feel anxious and worried!
2.
Could it have developed into a fistula? What are the clear symptoms to determine this? I do not have bleeding or pus, and there is no swelling around the anus, so do I need to see a doctor for another examination?
3.
There is a small protrusion at the 12 o'clock position outside the anus.
Is it a sentinel pile or a polyp formed from the fissure? Could it have any implications? Thank you for your response, Doctor!

Liu Xiaojie, 20~29 year old female. Ask Date: 2020/02/11

Dr. Ke Fangxu reply Surgery

1.
If there is no pain or bleeding, it can be considered healed.
Given your situation, it seems to have improved significantly, and there should still be room for further progress in the future.

2.
Chronic anal fissures that do not heal, combined with recurrent acute episodes, can lead to the formation of a fistula.
Based on your condition, it seems unlikely that this will occur.

3.
This is likely a polyp resulting from the fissure.
Generally, it does not affect daily activities and does not require special treatment.

Reply Date: 2020/02/11

More Info

Chronic anal fissures can be a painful and distressing condition, often leading to significant discomfort during bowel movements. It's great to hear that you've made positive lifestyle changes, such as increasing your water intake, consuming more fruits, and avoiding spicy and fried foods. These adjustments can indeed help in managing symptoms and promoting healing.

1. Healing Progress: The fact that you are no longer experiencing bleeding during bowel movements is a positive sign that your fissure may be healing. However, the persistent stabbing pain you feel could indicate that the fissure has not fully healed yet. Chronic anal fissures can take time to heal, and even after the bleeding stops, some discomfort may linger as the tissue continues to recover. It's important to continue your current regimen of warm sitz baths and topical medications, as these can aid in the healing process. If the pain persists or worsens, it may be worth consulting your healthcare provider for further evaluation.

2. Signs of Complications: You mentioned concerns about the fissure potentially evolving into a fistula. A fistula is an abnormal connection between the anal canal and the skin, which can occur as a complication of chronic fissures. Common symptoms of a fistula include persistent drainage of pus or blood, swelling around the anus, and pain that may not be relieved by typical treatments. Since you are not experiencing any bleeding, pus, or swelling, it seems less likely that you have developed a fistula. However, if you notice any new symptoms or if your pain increases, it would be prudent to seek a follow-up examination with your doctor.

3. Identifying Growths: The small growth you mentioned at the 12 o'clock position of your anus could be a sentinel pile, which is a common finding associated with chronic anal fissures. Sentinel piles are typically skin tags that form as a result of the fissure and are not usually harmful. However, they can sometimes become irritated or cause discomfort. It is essential to have any new growths evaluated by a healthcare professional to rule out other conditions, such as hemorrhoids or polyps, especially if there are changes in size, color, or associated symptoms.

In summary, while it sounds like you are on the right track with your management of chronic anal fissures, ongoing discomfort may warrant further evaluation. Regular follow-ups with your healthcare provider can help ensure that your condition is monitored and managed effectively. If you have any concerns about the growth or if your symptoms change, do not hesitate to reach out for medical advice. Your quality of life is important, and addressing these issues promptly can help you maintain your well-being.

Similar Q&A

Understanding Chronic Anal Fissures: Healing Time and Pain Management

I have had an anal fissure for 8 months. How much longer will it take to heal? My symptoms include pain but no bleeding. I have been worried about this every day. Thank you, doctor.

Dr. Ke Fangxu reply Surgery
The typical symptoms of anal fissures include pain during bowel movements accompanied by slight bleeding. The common causes are often constipation or diarrhea. The fundamental treatment is to improve bowel habits, along with warm sitz baths. Over-the-counter hemorrhoid suppositor...

Chronic Anal Fissures: Impact on Bowel Health and Healing

1. Based on your description, it sounds like you may be experiencing chronic anal fissures. Chronic anal fissures are defined as fissures that persist for more than eight weeks and can cause recurring pain and discomfort. 2. If the fissures have not healed over time, they can le...

Dr. Zhang Shuhao reply Surgery
Acute anal fissures typically heal within about a week if the wound is allowed to rest properly. However, if the affected area is repeatedly injured and symptoms persist for more than six weeks, it is classified as a chronic anal fissure. This may be due to tight anal sphincter m...

Chronic Anal Fissure: Seeking Solutions for Persistent Pain and Discomfort

Hello Doctor, I experienced a mild anal fissure due to bowel movements in early August. After a few days, thinking I had recovered, I engaged in anal intercourse. Since then, my fissure has not healed. Initially, I didn't pay much attention and bought over-the-counter ointme...

Dr. Ke Fangxu reply Surgery
The inflammation of the anal mucosa is not related to washing the buttocks with water unless water is being forced into the rectum, which is a very dangerous practice and should never be done. If there are anal fissures, it is essential to avoid constipation and diarrhea, as well...

Chronic Anal Fissures: Risks of Untreated Conditions and Alternatives

If chronic anal fissures are left untreated, they can lead to several complications. Although you may only experience mild pain during bowel movements and it doesn't significantly affect your daily life, the fissure can become more severe over time. This may result in increa...

Dr. Wang Qichao reply Surgery
Hello: Chronic anal fissures typically present with a triad of symptoms, which includes (1) ulceration, (2) anal tags, and (3) anal papillae. The chances of healing are usually low, and surgical intervention is often required. It is recommended that you first visit a colorectal s...