Effective Relief Methods for Anal Fissures Before Surgery

Methods for Relieving Anal Discomfort

Hello, my father has been feeling unwell recently.
Initially, we thought it was a cold, and after seeing a doctor and receiving IV fluids, there seemed to be no improvement.
Later, he started experiencing discomfort in his rectal area.
After consulting another doctor, he was diagnosed with an anal fistula.
The doctor prescribed some medication and mentioned a follow-up appointment, but did not indicate the need for surgery.
However, I have read that surgery seems to be the only solution for an anal fistula.
I would like to know if there are any methods to alleviate the pain during the period before surgery is arranged.

Xīn tè, 20~29 year old female. Ask Date: 2015/07/04

Dr. Ke Fangxu reply Surgery

The only definitive treatment for anal fistulas is surgery.
If there are no immediate plans for surgery, oral antibiotics and pain relievers can help alleviate the symptoms of swelling and pain until the pus within the fistula drains.
However, there is still a chance of recurrence.
Given that your father is around 60 years old, it is advisable to undergo surgery sooner rather than later, to avoid dealing with this issue for the next 20 years.

Reply Date: 2015/07/04

More Info

Anal fissures can be quite painful and uncomfortable, and while surgery may be a definitive solution for chronic cases, there are several effective relief methods that can be employed before considering surgical intervention. Here are some strategies that can help alleviate the discomfort associated with anal fissures:
1. Warm Sitz Baths: Taking warm sitz baths several times a day, especially after bowel movements, can help soothe the anal area. The warmth increases blood flow to the area, promoting healing and providing relief from pain and discomfort.

2. Topical Treatments: Over-the-counter topical anesthetics, such as lidocaine, can be applied to the affected area to numb the pain temporarily. Additionally, topical medications that contain nitroglycerin or calcium channel blockers can help relax the anal sphincter and increase blood flow, which may promote healing.

3. Fiber-Rich Diet: Increasing dietary fiber intake can help soften stools and make bowel movements less painful. Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of fiber. If necessary, fiber supplements like psyllium husk can also be beneficial.

4. Hydration: Drinking plenty of water is essential to prevent dehydration and ensure that stools remain soft. Aim for at least 8-10 glasses of water a day.

5. Stool Softeners: Over-the-counter stool softeners can be helpful in preventing straining during bowel movements, which can exacerbate fissures. Products containing docusate sodium are commonly used for this purpose.

6. Pain Relief Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen can help manage pain and discomfort associated with anal fissures.

7. Avoiding Straining: It’s important to avoid straining during bowel movements. If you feel the urge to go, try to respond promptly rather than holding it in, as this can lead to harder stools.

8. Proper Hygiene: Keeping the anal area clean is crucial. After bowel movements, gently clean the area with water or unscented wipes. Avoid using harsh soaps or scrubbing, as this can irritate the fissure.

9. Avoiding Irritants: Stay away from potential irritants such as scented toilet paper, soaps, or creams that may aggravate the area.

10. Consultation with a Specialist: If symptoms persist or worsen, it may be beneficial to consult a gastroenterologist or a colorectal surgeon. They can provide further evaluation and discuss other treatment options, including potential surgical interventions if necessary.

In summary, while surgery may be the ultimate solution for chronic anal fissures, there are several effective methods to relieve pain and promote healing in the interim. These methods focus on softening stools, reducing pain, and maintaining proper hygiene. If your father's condition does not improve with these conservative measures, it is essential to follow up with his healthcare provider for further evaluation and management.

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