Effective Treatments for Mild Anal Fissures: Your Complete Guide

Complete treatment of mild anal fissures?

Hello Dr.
Ke, I have read many of your articles and I think you are truly an amazing physician, so I hope you can answer my questions.
I apologize for the lengthy description, but I wanted to be very detailed, and I appreciate your patience.
Thank you!
About three weeks ago, I suddenly experienced pain while having a bowel movement, and there was a small amount of bright red blood when wiping.
I didn’t think much of it, but after a few days of irregular eating, I experienced pain and bleeding again.
Since then, for the past 19 days, I have been eating normally, including vegetables in every meal and drinking enough water.
I have not experienced pain or bleeding since then.
However, I still feel a slight discomfort during bowel movements.
It’s not as severe as the first two times, but there is a slight stinging sensation, and sometimes a burning feeling.
Most of the time, it’s just a mild stinging, which is hard to describe; I just know that I am not 100% healed.

I saw a doctor 14 days ago, and the physician said I had a mild anal fissure and prescribed Alcos-anal Supp.
(益痔康栓劑), but it states on the label that it is for hemorrhoids.
After using it for 14 days, I feel basically the same as I did 14 days ago, still experiencing slight stinging and occasional burning sensations.

So, I summarize my questions as follows:
1.
How can I achieve a complete 100% healing? I am not just referring to preventing recurrence, but I hope to return to the state I was in before I became ill.

2.
Why did the doctor prescribe hemorrhoid medication for my anal fissure?
3.
If I do not see a doctor anymore, will this stinging sensation heal on its own?
I hope you can help me with these three questions.
Thank you very much!

Xiwang neng qianyu de binghuan, 10~19 year old female. Ask Date: 2015/07/20

Dr. Ke Fangxu reply Surgery

1.
Anal fissures are not a serious condition, but they can be quite bothersome.
Although they are not life-threatening and typically cause only minor bleeding, the symptoms often persist for a period of time.
Healing is generally not an issue, but it is essential to maintain good bowel habits over an extended period and consistently perform warm sitz baths.
2.
While the medication "Yizhi Kang" suppositories are primarily used for treating hemorrhoids, they also have anti-inflammatory and analgesic effects for anal fissures.
However, some patients may experience increased pain after using them; in such cases, it is advisable to discontinue use.
3.
As I mentioned, the key to managing anal fissures is to improve bowel habits.
If bowel movements can be maintained normally, healing can occur spontaneously without the need to see a doctor.

Reply Date: 2015/07/20

More Info

Mild anal fissures can be quite uncomfortable and may lead to significant distress, as you've described. It's great that you're seeking information and guidance on how to effectively manage this condition. Let's address your questions one by one and provide a comprehensive overview of effective treatments for mild anal fissures.

1. How to Achieve Complete Healing from Anal Fissures
To achieve complete healing from anal fissures, it is essential to focus on several key aspects:
- Dietary Changes: A high-fiber diet is crucial. Incorporate plenty of fruits, vegetables, whole grains, and legumes into your meals. This will help soften your stool and make bowel movements easier, reducing the strain that can exacerbate fissures.

- Hydration: Drinking plenty of water is equally important. Aim for at least 8-10 glasses of water a day to help keep your stool soft.

- Stool Softeners: Over-the-counter stool softeners, such as docusate sodium (Colace), can be beneficial in preventing hard stools that may aggravate fissures.

- Topical Treatments: In addition to the Alcos-anal Suppositories you mentioned, consider using topical nitroglycerin ointment or calcium channel blockers like diltiazem or nifedipine. These medications can help relax the anal sphincter and promote healing by increasing blood flow to the area.

- Warm Sitz Baths: Taking warm sitz baths for about 10-15 minutes several times a day, especially after bowel movements, can help soothe the area, reduce pain, and promote healing.

- Avoid Straining: It's essential to avoid straining during bowel movements. If you feel the urge to go, try not to delay it, as this can lead to harder stools.

2. Why Was a Hemorrhoid Treatment Prescribed for an Anal Fissure?
The reason your doctor prescribed a hemorrhoid treatment for your anal fissure is that the symptoms can often overlap. Both conditions can cause pain, bleeding, and discomfort during bowel movements. The medications used for hemorrhoids, such as topical anesthetics and anti-inflammatory agents, can also provide relief for fissures. However, if you feel that the treatment is not effective, it’s important to communicate this with your healthcare provider, as they may need to adjust your treatment plan.

3. Will the Pain Resolve on Its Own Without Medical Intervention?
While mild anal fissures can sometimes heal on their own, especially with proper self-care and dietary adjustments, it is not guaranteed. The discomfort you are experiencing may persist if the underlying causes are not addressed. If the fissure does not heal within a few weeks, or if the pain worsens, it is advisable to consult a healthcare professional. They may recommend further treatments, such as prescription medications or, in rare cases, surgical options if conservative measures fail.

Additional Considerations
- Regular Follow-ups: If your symptoms persist or worsen, regular follow-ups with your healthcare provider are essential. They can monitor your condition and make necessary adjustments to your treatment plan.

- Avoiding Irritants: Be mindful of any products that may irritate the anal area, such as scented toilet paper or harsh soaps. Opt for gentle, unscented products to minimize irritation.

- Stress Management: Stress can impact bowel habits, so incorporating stress management techniques such as mindfulness, yoga, or meditation may also be beneficial.

In conclusion, while mild anal fissures can be uncomfortable, they are often manageable with lifestyle changes and appropriate treatments. By focusing on a high-fiber diet, staying hydrated, using topical treatments, and practicing good bowel habits, you can work towards achieving complete healing. If symptoms persist, don't hesitate to seek further medical advice. Your health and comfort are paramount, and there are effective strategies available to help you return to your pre-illness state.

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