Anal Fissures: Symptoms, Treatment, and Recovery Tips - Surgery

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Anal fissure with painful bowel movements and blood?


A month ago, I experienced several days of diarrhea.
At first, it wasn't a big deal, but then I developed small tears around the anus, which became very itchy and affected my sleep.
After the diarrhea stopped, I had normal bowel movements, but the area around the anus was painful, and wiping would cause bleeding.
Additionally, one side of the area became swollen and firm.
After cleaning, there would still be some discharge each time.
Previously, I would feel the urge to have a bowel movement right after finishing my meals, but now I am afraid to use the bathroom.
I eventually went to see a doctor, who prescribed anti-itch medication and ointment.
It helped a bit, but I still experienced slight pain and a small amount of blood during bowel movements.
After a month, I consulted another doctor who, after hearing my description, diagnosed me with anal fissures and prescribed FAKTU ointment.
I was told to apply it externally, but the pharmacy didn't clarify that.
I tend to have diarrhea easily, and even when avoiding dairy, I sometimes experience loose stools and hard bowel movements after eating other foods.
Does this mean my recovery will be particularly slow and feel endless? Thank you for the doctor's explanation.

Shan, 20~29 year old female. Ask Date: 2021/08/14

Dr. Ke Fangxu reply Surgery


The typical symptoms of anal fissures include pain during bowel movements accompanied by slight bleeding.
The pain can persist for several days, sometimes exceeding a week.
The common causes are often related to constipation or diarrhea.
The fundamental treatment involves addressing the bowel movement issues, along with warm sitz baths.
Warm sitz baths can help alleviate pain, maintain cleanliness, and promote blood circulation.
Additionally, hemorrhoid suppositories and ointments can be used; the ointment can be applied directly to the painful area.
If symptoms persist without improvement, it is advisable to consult a physician for further evaluation.

Reply Date: 2021/08/14

More Info


Anal fissures are small tears in the lining of the anus, often resulting from trauma during bowel movements, particularly when passing hard or large stools. They can cause significant discomfort, including sharp pain during and after bowel movements, itching, and sometimes bleeding. Given your history of diarrhea and the subsequent development of symptoms, it is likely that the frequent bowel movements contributed to the formation of the fissure.


Symptoms of Anal Fissures
The symptoms you described align with typical presentations of anal fissures:
- Pain: Sharp pain during bowel movements, which may persist afterward.

- Bleeding: Bright red blood on the toilet paper or in the stool.

- Itching: Irritation around the anal area.

- Swelling: Inflammation or swelling around the fissure site.


Treatment Options
The treatment for anal fissures typically includes both conservative and medical approaches:
1. Dietary Changes: Increasing fiber intake can help soften stools, making bowel movements less painful. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Staying hydrated is also crucial.

2. Topical Treatments: The Faktu Ointment prescribed to you is a topical treatment that can help soothe the area and promote healing. It is generally applied externally around the anal area. However, if directed by your healthcare provider, it may also be applied internally, but this should be clarified with your doctor.

3. Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help relieve pain and promote healing by increasing blood flow to the area.

4. Pain Relief: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage discomfort.

5. Avoiding Straining: It’s essential to avoid straining during bowel movements. If you feel the urge to go, try to respond promptly rather than holding it in.

6. Medications: In some cases, doctors may prescribe topical nitroglycerin or calcium channel blockers to help relax the anal sphincter and promote healing.


Recovery Tips
- Follow-Up: Since you have a history of diarrhea, it’s important to manage this condition as well. Frequent diarrhea can exacerbate fissures and delay healing. Discuss with your doctor about potential dietary triggers or medications that can help regulate your bowel movements.

- Regular Check-Ups: If symptoms persist or worsen, further evaluation may be necessary. Chronic fissures may require more advanced treatments, such as Botox injections or surgical options.

- Mental Health: Anxiety about bowel movements can create a cycle of avoidance, which may worsen constipation or diarrhea. Consider discussing these feelings with a healthcare provider, as they can offer strategies to manage anxiety related to bowel habits.


Conclusion
Anal fissures can be painful and frustrating, especially when they interfere with daily activities and sleep. With appropriate treatment and lifestyle modifications, most fissures heal within a few weeks. However, if you continue to experience symptoms, it’s essential to maintain communication with your healthcare provider to explore further options and ensure that you are on the path to recovery. Remember, healing takes time, and addressing underlying issues like diarrhea can significantly improve your situation.

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