Scar Tissue in the Anus: Causes, Symptoms, and Solutions

Q: Scar Tissue in the Anus: Causes, Symptoms, and Solutions

Hello： I am not sure what "comprehensive therapy" entails, nor do I fully understand what "scarring" refers to. <br>However, Dr. <br>Chang-Jian is a senior figure in our colorectal surgery department, and his diagnosis should be reliable. <br>If the current issues are bleeding an

Scar tissue in the anal canal?

Hello Dr.
Ke,
In April of this year, I visited a traditional Chinese medicine clinic in Banqiao for what they referred to as "comprehensive therapy" for my anal fissures and hemorrhoids.
Currently, I am experiencing difficulties during bowel movements, particularly when the stool is larger—about the size of two thumbs—or harder, which makes it challenging to pass.
It often takes nearly five minutes, and I frequently end up with skin tears, resulting in some bleeding.
I understand that these are minor fissures, and I have been applying a topical medication called Baoshizining.

I consulted Dr.
Chang Jian-Jun at Chang Gung Memorial Hospital, and both examinations in July and December revealed a scar near the upper area of the anal opening, which I believe is a result of the comprehensive therapy.
This scar seems to be causing the skin to tear during bowel movements.
Could this scar be affecting the elasticity of my anal sphincter? I also inquired about the possibility of anal stenosis, but the doctor assured me that it was not the case, as the results from the rectal examination were normal.
Dr.
Ke, I am troubled by the fact that I experience skin tears one to three times every couple of months.
The doctor advised me to eat more fruits to soften my stool, but sometimes, if I do not have a bowel movement for just one day, it becomes more difficult the next day, leading to a painful sensation and the need to apply medication.
Is it okay to frequently apply Baoshizining? Will this cause the skin inside the anus to become thinner, considering it contains steroids? I truly regret going to that traditional Chinese medicine clinic, and I am unsure of how to alleviate my suffering from skin tears and anal fissures.
I also asked Dr.
Chang about the feasibility of anal surgery, but he only prescribed me medication to apply.
It seems that I need to rely on myself to normalize my bowel movements and eat more fruits.
Are there no other options available? For instance, would relaxing the anal sphincter help with easier bowel movements, and would that pose any risks? Additionally, is there any ointment that could help reduce the scar, and would regular finger massage be effective? I take warm sitz baths almost every day.
I apologize for asking so many questions, and I sincerely appreciate your time in answering them!

ku, 30~39 year old female. Ask Date: 2009/12/06

Dr. Ke Fangxu reply Surgery

Hello: I am not sure what "comprehensive therapy" entails, nor do I fully understand what "scarring" refers to.
However, Dr.
Chang-Jian is a senior figure in our colorectal surgery department, and his diagnosis should be reliable.
If the current issues are bleeding and pain without fecal incontinence or severe pain, then there is likely no damage to the sphincter or anal stenosis.
Simple internal and external hemorrhoids can indeed cause the symptoms you described.
If the hemorrhoids are not affecting your daily life or causing anemia, using topical medications to alleviate symptoms is acceptable.
Unless the discomfort significantly impacts your daily activities, I would not recommend surgical treatment.
Procedures such as anal reconstruction or sphincterotomy are performed, but they must have appropriate indications.
A reputable physician would not perform such surgeries lightly.
I suggest you focus on treating the bowel movement issues rather than worrying about scarring.
If the symptoms are not severe, there may not be a need for specific treatments; daily warm sitz baths should suffice.

Reply Date: 2009/12/06

More Info

Understanding scar tissue in the anus, particularly in the context of anal fissures and related complications, is essential for addressing the discomfort and challenges you are experiencing. Scar tissue can form as a result of injury, surgery, or chronic inflammation, and it can significantly affect the function of the anal sphincter and the overall comfort during bowel movements.

Causes of Scar Tissue in the Anus
Scar tissue in the anal region can arise from several factors:
1. Anal Fissures: These are small tears in the lining of the anus, often caused by passing hard stools or straining during bowel movements. Repeated fissures can lead to scar tissue formation.

2. Surgical Procedures: Any surgical intervention in the anal area, including procedures for hemorrhoids or fissures, can result in scar tissue.

3. Chronic Inflammation: Conditions such as inflammatory bowel disease (IBD) can lead to chronic irritation and scarring.

4. Trauma: Any injury to the anal area, whether from childbirth, anal intercourse, or other forms of trauma, can contribute to scar formation.

Symptoms Associated with Scar Tissue
The symptoms you are experiencing, such as difficulty with bowel movements, pain, and bleeding, are common in individuals with scar tissue in the anal region. The scar tissue can restrict the elasticity of the anal sphincter, making it harder for the anus to accommodate larger or harder stools. This can lead to a cycle of pain and further injury, as you described.

Solutions and Management Strategies
1. Dietary Adjustments: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools, making them easier to pass. Staying well-hydrated is also crucial.

2. Topical Treatments: While you mentioned using a topical medication (保痔寧), which contains steroids, it's important to use such treatments cautiously. Prolonged use of steroids can thin the skin and may exacerbate the problem. Discuss with your doctor about alternative topical treatments that may be less irritating.

3. Sitz Baths: Regular warm sitz baths can help soothe the area and promote healing. This practice can also help relax the anal sphincter, making bowel movements less painful.

4. Medications: Your doctor may prescribe medications to help manage pain and promote healing. These could include topical anesthetics or other agents that promote healing.

5. Physical Therapy: In some cases, pelvic floor physical therapy can help improve muscle function and reduce tension in the anal sphincter, potentially alleviating some of the discomfort.

6. Surgical Options: If conservative measures fail, surgical options may be considered. Procedures such as lateral internal sphincterotomy can help relieve tension in the anal sphincter and promote healing. However, these options should be discussed thoroughly with a colorectal surgeon.

7. Massage and Manual Therapy: While gentle massage may help in some cases, it is crucial to approach this with caution. Overly aggressive manipulation can lead to further irritation or injury.

8. Monitoring and Follow-Up: Regular follow-up with your healthcare provider is essential to monitor the condition and adjust treatment as necessary.

Conclusion
It is understandable to feel frustrated with the ongoing issues related to scar tissue and anal fissures. While dietary changes and topical treatments can provide relief, it is essential to work closely with your healthcare provider to develop a comprehensive management plan tailored to your specific needs. If you continue to experience significant discomfort or complications, seeking a second opinion or consulting a specialist in colorectal surgery may provide additional insights and options for treatment. Remember, addressing the underlying causes of your symptoms is key to achieving long-term relief and improving your quality of life.

Similar Q&A

Post-Hemorrhoidectomy Scar Tissue: Pain Relief and Treatment Options

Hello, doctor. I apologize for the interruption. I underwent a traditional hemorrhoidectomy in June of this year, but three months post-surgery, I have been experiencing ongoing pain and rectal bleeding. The physician explained that scar tissue is causing anal stenosis, and I hav...

Dr. Ke Fangxu reply Surgery
Anal stenosis is a rare but serious complication following hemorrhoidectomy. It is generally recommended to first undergo conservative treatment, which includes anal dilation and topical medication. If the treatment persists for more than six months and pain remains intolerable, ...

Understanding Anal Skin Tears: Causes, Symptoms, and Treatment

If you have been experiencing bleeding and pain after wiping too hard, it is possible that you have caused a tear in the anal tissue, commonly known as an anal fissure. This can lead to discomfort, moisture, and bleeding from the anus. It is important to keep the area clean and a...

Dr. Chen Ronghong reply Surgery
Hello, if there is a tear around the anus, you can temporarily switch to water washing or moist wipes, but be sure to use gentle pressure. At the same time, avoid consuming spicy foods to prevent irritating the wound. If the wound does not heal over time or keeps recurring, you s...

Understanding Anal Skin Tags: Causes, Symptoms, and Treatment Options

There is a flesh-colored lump about 1 cm in size at the anal opening, present for at least 5 or 6 years. Aside from occasional constipation, which causes slight bleeding when wiping the anus and during bowel movements, there is no discomfort, and it does not hurt when pressed. It...

Dr. Chen Qifeng reply Gastroenterology and Hepatology
This falls under the scope of colorectal surgery.

Understanding Anal Skin Lesions: Causes and Treatment Options

There is a skin tear on the left side of the anus, which causes a stinging pain. Applying lotion provides relief, but after a few days, there is again stinging pain after wiping following a bowel movement. Additionally, there is a small lump near the anus that feels slightly swol...

Dr. Xu Kaixi reply Surgery
Based on your description, it is possible that it is hemorrhoidal tissue. It is recommended to visit a surgical outpatient clinic for examination.