Is It Anal Fissure or Hemorrhoids? Your Symptoms

Q: Is It Anal Fissure or Hemorrhoids? Your Symptoms

Hello： In response to your question, based on your description, it seems more likely that you have an anal fissure. <br>A definitive diagnosis should be made by a physician. <br>However, it is advisable to avoid straining during bowel movements. <br>If you can prevent constipatio

Could it be an anal fissure?

A few days ago, I suddenly had to strain a lot while using the restroom, which caused significant pain in my anus.
When I wiped, there was a lot of fresh blood, and I felt a protruding lump.
After returning home, I took a shower and applied hemorrhoid ointment.
When I inserted my finger to apply the medication, I didn't feel the aforementioned lump, but I did touch what I believe is the anal sphincter.
I felt a slightly protruding wound about a centimeter inside.
After applying the ointment for two to three days, my bowel movements improved, and the lump seemed to go away.
However, I still occasionally have the urge to defecate every morning.
This morning, when I used the restroom, I noticed a bit of blood when wiping and felt a small lump again.
Occasionally, straining during bowel movements doesn't seem to be very painful.
Doctor, could this situation be an anal fissure or hemorrhoids? I appreciate your help, thank you! (I have had a recurrence in the past but didn't see a doctor; I managed it with ointments and hemorrhoid medication.)

Niming, 20~29 year old female. Ask Date: 2013/08/09

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, based on your description, it seems more likely that you have an anal fissure.
A definitive diagnosis should be made by a physician.
However, it is advisable to avoid straining during bowel movements.
If you can prevent constipation and take warm sitz baths for one to two weeks, you should see significant improvement.
If there is no improvement, it is best to consult a physician for further evaluation.

Reply Date: 2013/08/09

More Info

When considering whether your symptoms indicate an anal fissure or hemorrhoids, it's essential to understand the characteristics and differences between these two conditions. Both can cause pain and bleeding during bowel movements, but they have distinct features that can help in identifying the underlying issue.

Anal Fissure: An anal fissure is a small tear 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, which can be severe. You may also notice bright red blood on the toilet paper or in the stool. The pain can lead to a fear of bowel movements, which can create a cycle of constipation and further straining. The area around the fissure may appear swollen or have a small lump of tissue (sentinel pile) that forms as a result of the fissure.

Hemorrhoids: Hemorrhoids are swollen veins in the rectal area, which can be either internal or external. Internal hemorrhoids are usually not visible and can cause bleeding during bowel movements, but they typically do not cause pain unless they prolapse (extend outside the anus). External hemorrhoids can be painful, especially if a blood clot forms within them (thrombosed hemorrhoid). Symptoms include pain, swelling, and a lump near the anus, along with bleeding.

Based on your description, it sounds like you may be experiencing symptoms of both conditions. The presence of bright red blood after bowel movements and the feeling of a "bump" or "lump" could suggest hemorrhoids, especially if the lump is external. However, the sharp pain and the mention of a "wound" or "tear" could indicate an anal fissure, particularly if you have been straining during bowel movements.

What to Do Next:
1. Self-Care: Continue using topical treatments for hemorrhoids, such as over-the-counter creams or ointments. Warm sitz baths can also help soothe the area and promote healing.

2. Dietary Changes: Increase your fiber intake to soften stools and reduce straining. Drinking plenty of water and incorporating fruits, vegetables, and whole grains can help.

3. Avoid Straining: Try to avoid straining during bowel movements. If you feel the urge to go, don't delay it.
4. Consult a Healthcare Provider: Given your history of recurrent symptoms, it would be wise to consult a healthcare provider for a proper diagnosis. They may perform a physical examination and possibly recommend further tests to determine the exact cause of your symptoms.

In conclusion, while your symptoms could indicate either an anal fissure or hemorrhoids, a healthcare professional can provide a definitive diagnosis and appropriate treatment plan. Early intervention can help prevent complications and improve your quality of life.

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