Anal Fissures and Hemorrhoids: Symptoms and Recovery

Anal fissure Hemorrhoids

Hello Doctor: My symptoms started on Wednesday after eating mochi and having salad for several consecutive days.
By Thursday noon, I suddenly had diarrhea (with muddy stools) and noticed blood in my stool since then (the amount was quite significant).
I experienced pain at the anus when having a bowel movement, which has continued for six days.
On the sixth day, I felt that the blood volume decreased, but I still experienced pain near the anus.
On the fifth day, I suddenly had a fever, chills, and muscle aches, but it resolved quickly.
I have not taken any oral or topical medications, as I wanted to let it heal on its own.
I was having bowel movements 2-3 times a day, which has now reduced to twice a day.

1.
Could this be anal fissure or hemorrhoids?
2.
How many days does it typically take to heal on its own without medication?
3.
Is there a risk of developing other infections? Thank you!

Qi, 30~39 year old female. Ask Date: 2023/05/23

Dr. Zhang Shuhao reply Surgery

1.
Anal fissures and hemorrhoids typically do not cause fever or chills; other underlying causes should be considered.
2.
Mild hemorrhoids and anal fissures can benefit from warm sitz baths and increased fluid intake to maintain smooth bowel movements; symptoms may improve within a week, but for more severe cases, medical consultation and treatment are recommended.
3.
Hemorrhoids rarely lead to infection unless they become thrombosed and cause ischemic necrosis, so if symptoms such as fever and chills occur, it is important to seek medical attention promptly.

Reply Date: 2023/05/23

More Info

Understanding anal fissures and hemorrhoids is crucial for addressing your symptoms effectively. Based on your description, it seems you are experiencing significant discomfort and bleeding after bowel movements, which can be indicative of either an anal fissure or hemorrhoids.

1. Differentiating Between Anal Fissures and Hemorrhoids:
- Anal Fissures: These are small tears 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, and you may notice bright red blood on the toilet paper or in the stool. The pain can be severe and may last for hours after a bowel movement.

- Hemorrhoids: These are swollen veins in the rectal area, which can be internal or external. Symptoms include itching, discomfort, and bleeding during bowel movements. The blood is usually bright red and may be seen on the stool or toilet paper. Hemorrhoids can also cause a feeling of fullness or pressure in the rectum.

Given that you experienced significant pain and bleeding, it is possible that you may have an anal fissure, especially if the pain is sharp and intense. However, without a physical examination, it is difficult to provide a definitive diagnosis.

2. Self-Healing Timeline:
- The healing time for anal fissures can vary. Many fissures heal within a few days to a few weeks with proper care, including dietary changes to ensure softer stools and increased hydration. However, if the fissure is chronic or if you continue to experience pain and bleeding, it may take longer, and medical intervention may be necessary.

- For hemorrhoids, the healing process can also take a few days to weeks, depending on the severity. Over-the-counter treatments can help alleviate symptoms and promote healing.

3. Risk of Infection:
- While anal fissures and hemorrhoids themselves do not typically lead to infections, the presence of blood and irritation can create an environment where infections might occur, especially if there is significant trauma to the area. Symptoms of infection may include increased pain, swelling, redness, or discharge. If you notice any of these signs, it is essential to seek medical attention promptly.

Recommendations:
- Dietary Changes: Increase your fiber intake through fruits, vegetables, and whole grains to help soften your stools. Staying well-hydrated is also crucial.

- Warm Baths: Taking warm sitz baths can help soothe the area and promote healing.

- Avoid Straining: Try to avoid straining during bowel movements, as this can exacerbate fissures and hemorrhoids.

- Over-the-Counter Treatments: If symptoms persist, consider using over-the-counter topical treatments for hemorrhoids or consult with a healthcare provider for appropriate medications.

If your symptoms do not improve within a week or if they worsen, it is advisable to consult a healthcare professional for a thorough evaluation and potential treatment options. Early intervention can prevent complications and promote faster recovery.

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