Anal Fissures: Causes, Symptoms, and Treatment Options

Anal fissure issues?

Before the long holiday, I experienced nausea and bloating due to the side effects of antidepressant medication, which made it difficult to eat.
I took over-the-counter medication, but it didn't help, and I ended up visiting the emergency room.
After returning from the ER, I had diarrhea about three times.
In the past few days, I took acetaminophen before meals, Moshu gastric protective film after meals, and Gas-X for gas relief, which helped normalize my bowel movements.
However, my stools still resemble diarrhea, and now there is blood in my stool.
Could this be due to diarrhea causing a fissure to reopen?

Xue Er, 20~29 year old female. Ask Date: 2023/06/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

It may be bleeding from internal hemorrhoids; you can stop taking Moshuwei, and if necessary, use an anal ointment.

Reply Date: 2023/06/23

More Info

Anal fissures are small tears in the lining of the anus, which can cause significant discomfort and pain, especially during bowel movements. Understanding the causes, symptoms, and treatment options for anal fissures is essential for effective management and recovery.

Causes of Anal Fissures
Anal fissures can occur due to a variety of reasons, including:
1. Constipation and Straining: Hard, dry stools can stretch the anal canal, leading to tears. Straining during bowel movements is a common cause.

2. Diarrhea: Frequent loose stools can irritate the anal area, making it more susceptible to fissures.

3. Childbirth: Women may experience anal fissures during or after childbirth due to the pressure exerted during delivery.

4. Anal Intercourse: This can cause trauma to the anal area, leading to fissures.

5. Underlying Health Conditions: Conditions such as Crohn's disease or other inflammatory bowel diseases can increase the risk of developing anal fissures.

Symptoms of Anal Fissures
The symptoms of anal fissures can vary but typically include:
- Pain: Sharp pain during and after bowel movements is the hallmark symptom. This pain can be severe and may last for several hours.

- Bleeding: Bright red blood may be seen on the toilet paper or in the toilet bowl after a bowel movement.

- Itching or Irritation: The area around the anus may feel itchy or irritated.

- Visible Tear: In some cases, a small tear may be visible at the anal opening.

Treatment Options
Treatment for anal fissures focuses on relieving pain, promoting healing, and preventing future occurrences. Here are some common treatment options:
1. Dietary Changes: Increasing fiber intake can help soften stools and reduce straining. Drinking plenty of water is also essential.

2. Over-the-Counter Medications: Stool softeners can help ease bowel movements. Pain relief medications, such as acetaminophen or ibuprofen, can alleviate discomfort.

3. Topical Treatments: Creams or ointments containing nitroglycerin or calcium channel blockers can help relax the anal sphincter and promote healing.

4. Warm Baths: Soaking in warm water (sitz baths) can provide relief and promote healing by increasing blood flow to the area.

5. Botox Injections: In some cases, Botox may be injected into the anal sphincter to relieve muscle spasms and promote healing.

6. Surgery: If conservative treatments fail, surgical options such as lateral internal sphincterotomy may be considered to relieve tension in the anal sphincter.

Addressing Your Concerns
In your case, it seems that the combination of diarrhea and the medications you have taken may have contributed to the reopening of a previous fissure or the development of a new one. The presence of blood in your stool, especially after experiencing diarrhea, can indicate that the anal fissure has been aggravated. It is crucial to monitor your symptoms closely.

If you continue to experience bleeding or severe pain, it is advisable to consult a healthcare professional. They may recommend further evaluation, such as a physical examination or possibly an endoscopy, to rule out other underlying conditions. Additionally, they can provide tailored advice on managing your symptoms and preventing future fissures.

In summary, anal fissures can be painful and distressing, but with appropriate management, most individuals can find relief and promote healing. Dietary modifications, proper hydration, and topical treatments are often effective first-line strategies. If symptoms persist or worsen, seeking medical attention is essential to ensure proper care and avoid complications.

Similar Q&A

Understanding Anal Fissures: Symptoms, Treatments, and Management

Hello Doctor: Since late April to early May, after experiencing diarrhea, I began to have issues with anal fissures. Initially, the pain was very severe, and about a week later, I visited a clinic for treatment. After applying medication for about a week, I felt no discomfort. Ho...

Dr. Ke Fangxu reply Surgery
1. If the stool is hard, experiencing pain during bowel movements is a normal phenomenon and does not necessarily indicate an anal fissure. 2. If it is a self-paid purchase, I believe it is unnecessary because flavonoids are classified as food products and have not received medi...

Understanding Anal Fissures: Symptoms, Diet, and Recovery Time

What should I eat for anal fissures? The pain can be so severe that I can't sleep. How long will it take to heal? Also, for the past few days, my left buttock has been hard and painful. What could those two lines be?

Dr. Ke Fangxu reply Surgery
The typical symptoms of an anal fissure are 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 suppositorie...

Understanding Anal Fissures: Causes, Symptoms, and Treatment Options

I have been experiencing anal pain after bowel movements for almost a month. I consulted a doctor who diagnosed it as an anal fissure. I have been using topical medications and taking sitz baths, but the pain comes and goes. I had a period where the pain was less severe, so I sto...

Dr. Ke Fangxu reply Surgery
The typical symptoms of anal fissures include pain during bowel movements accompanied by slight bleeding. If there is concurrent bleeding from hemorrhoids, the amount of blood may be greater. The primary cause of anal fissures is usually hard stools; however, diarrhea, frequent b...

How to Prevent and Manage Anal Fissures and Related Symptoms

Hello, Doctor. (1) A few years ago, I had anal fissures and hemorrhoids and received treatment at the hospital, and I have since recovered. However, I have noticed that during anal intercourse with my partner, there is a high likelihood of recurrence (almost always), resulting in...

Dr. Zhang Shuhao reply Surgery
1. If you have previously experienced anal fissures, it is essential to use ample lubrication and gradually dilate the anus before anal intercourse. Insertion should only occur when the anal sphincter is completely relaxed. If you experience sharp pain during the process (the pai...