Anal Fissures: Symptoms, Causes, and Recovery Tips

Anal fissure issues?

Today, I tried anal intercourse for the first time with my boyfriend.
He penetrated me, and it was very painful at first.
After we finished, I went to the bathroom and noticed some bleeding, and it hurts a lot.
Is this an anal fissure? Will it heal on its own? Do I need any special rest?

LEM, 10~19 year old female. Ask Date: 2015/07/09

Dr. Xiao Yongxun reply Internal Medicine

Anal fissure is a condition that falls under the realm of colorectal surgery, and I am not a subspecialist in that field.
The following explanation is based on the general clinical understanding of a physician: An anal fissure refers to a tear that occurs within the anal canal.
It typically presents with sharp, severe pain, especially during or after bowel movements.
There may also be a small amount of bright red bleeding.
Due to irritation from adjacent external hemorrhoids (sentinel pile) at the anal opening, it may lead to secretion and itching, which can cause discomfort and result in urinary difficulties or increased frequency of urination.

Reply Date: 2015/07/09

More Info

Anal fissures are small tears in the lining of the anus, often resulting from trauma or excessive stretching. They can be quite painful and may cause bleeding, especially during bowel movements. Based on your description, it is possible that you have experienced an anal fissure, particularly if you felt significant pain during and after anal intercourse, followed by bleeding.

Symptoms of Anal Fissures
The primary symptoms of anal fissures include:
1. Pain: Sharp pain during and after bowel movements or anal intercourse.

2. Bleeding: Bright red blood on the toilet paper or in the toilet bowl after a bowel movement.

3. Itching or irritation: The area around the anus may feel itchy or irritated.

4. Visible tear: In some cases, a fissure may be visible as a small tear in the skin around the anus.

Causes of Anal Fissures
Anal fissures can occur due to several reasons:
- Trauma: This can include anal intercourse, as in your case, or passing hard stools.

- Chronic constipation or diarrhea: Straining during bowel movements can lead to fissures.

- Inflammatory conditions: Conditions like Crohn's disease or ulcerative colitis can also contribute to the development of fissures.

Recovery Tips
1. Rest and Avoid Strain: After experiencing pain and bleeding, it’s essential to allow your body to heal. Avoid any activities that may further irritate the area, including anal intercourse, until you are fully healed.

2. Warm Baths: Taking warm baths (sitz baths) can help soothe the area and promote healing. Soaking for about 10-15 minutes several times a day can provide relief.

3. Topical Treatments: Over-the-counter creams or ointments containing hydrocortisone can reduce inflammation and pain. Additionally, topical anesthetics may provide temporary relief.

4. Increase Fiber Intake: To prevent constipation and make bowel movements easier, increase your intake of fiber-rich foods (fruits, vegetables, whole grains) and drink plenty of water.

5. Stool Softeners: If you are experiencing constipation, consider using stool softeners to ease bowel movements.

6. Avoid Irritants: Avoid using harsh soaps or wipes in the anal area, as these can cause further irritation.

7. Consult a Healthcare Provider: If the pain and bleeding persist, or if you notice any signs of infection (such as increased redness, swelling, or discharge), it’s crucial to seek medical advice. A healthcare provider can assess the situation and may prescribe medications or recommend further treatment options.

When to Seek Medical Attention
If the symptoms do not improve within a few days, or if you experience severe pain, persistent bleeding, or signs of infection, you should consult a healthcare professional. They may perform a physical examination and recommend treatments such as prescription medications or, in some cases, surgical options if the fissure does not heal.

Conclusion
While anal fissures can be painful and distressing, they often heal with proper care and attention. It’s essential to listen to your body and give it the time it needs to recover. Avoiding further trauma to the area and maintaining a healthy diet can significantly aid in the healing process. If you have any concerns or if symptoms persist, don’t hesitate to reach out to a healthcare provider for guidance and support.

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