Effective Remedies for Anal Fissures: Beyond Hemorrhoid Ointments

Hemorrhoid ointment for anal fissures?

Hello, doctor.
Every time I have a bowel movement, I feel a sensation as if my anus is about to裂傷, and it feels like the anal wall is very thin.
I apply hemorrhoid cream daily, but there is no improvement.
I would like to ask if you have any recommended methods.
Thank you.

toms, 20~29 year old female. Ask Date: 2022/03/06

Dr. Zhang Shuhao reply Surgery

Anal fissures are primarily caused by tight anal sphincter muscles combined with straining during bowel movements.
It is recommended to increase fluid intake and consume more fruits and vegetables to prevent constipation.
Taking warm sitz baths two to three times a day, gently patting dry before applying ointment, and avoiding excessive straining during bowel movements are advised.
Acute anal fissures typically heal within about a week as long as the area is not subjected to further strain or irritation.

Reply Date: 2022/03/06

More Info

Anal fissures are small tears in the lining of the anus that can cause significant pain and discomfort, especially during bowel movements. While hemorrhoid ointments can provide temporary relief, they may not address the underlying issues associated with anal fissures. Here are some effective remedies and strategies that can help alleviate the symptoms and promote healing.

1. Dietary Changes
One of the most effective ways to manage anal fissures is to improve your diet to promote softer stools and regular bowel movements. This can be achieved by:
- Increasing Fiber Intake: Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Fiber helps to bulk up stools and makes them easier to pass, reducing strain during bowel movements.

- Staying Hydrated: Drink plenty of water throughout the day. Adequate hydration helps soften stools and prevents constipation.

2. Topical Treatments
While you mentioned using hemorrhoid ointments, there are other topical treatments specifically designed for anal fissures:
- Nitroglycerin Ointment: This prescription medication can help relax the anal sphincter, increasing blood flow to the area and promoting healing.

- Calcium Channel Blockers: Topical medications like diltiazem can also help relax the anal sphincter and improve blood flow.

- Lidocaine Cream: This can provide temporary pain relief by numbing the area.

3. Sitz Baths
Taking warm sitz baths can be very soothing for anal fissures. Soaking the anal area in warm water for 10-15 minutes several times a day can help relax the muscles, reduce pain, and promote healing. Adding Epsom salts may provide additional relief.

4. Over-the-Counter Pain Relief
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help manage pain associated with anal fissures. However, consult with a healthcare provider before starting any new medication.

5. Avoiding Straining
Straining during bowel movements can exacerbate fissures. To avoid this, consider:
- Establishing a Routine: Try to have a regular time for bowel movements, allowing your body to develop a natural rhythm.

- Using a Stool Softener: Over-the-counter stool softeners can help make bowel movements easier and less painful.

6. Medical Interventions
If conservative measures do not provide relief, it may be necessary to consult a healthcare provider for further evaluation. In some cases, procedures such as:
- Botulinum Toxin Injections: These can help relax the anal sphincter and promote healing.

- Surgery: In severe cases, a surgical procedure called lateral internal sphincterotomy may be recommended to relieve tension in the anal sphincter.

7. Lifestyle Modifications
Incorporating regular exercise into your routine can help promote healthy bowel function and prevent constipation. Additionally, avoiding prolonged sitting on the toilet can reduce pressure on the anal area.

Conclusion
If you are experiencing persistent discomfort despite using hemorrhoid ointments, it is essential to explore these alternative remedies and consult with a healthcare professional for a tailored treatment plan. Anal fissures can be a chronic issue, but with the right approach, they can heal effectively, allowing you to regain comfort and normalcy in your daily life.

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