Managing Anal Stricture and Fissures: Effective Home Remedies

Anal stenosis leading to anal fissures?

I have been experiencing some pain and difficulty during bowel movements, and occasionally there is a bit of blood on the toilet paper.
Recently, the bleeding has become more frequent and the pain has increased.
After an examination, the doctor diagnosed me with anal fissures and mentioned that my anus is somewhat narrow and difficult to relax.
Although surgery is not yet necessary, I need to soak in warm water and perform massages.
I would like to ask if it is possible to use my fingers or a small, soft anal plug (1-2 cm wide) with lubricant for insertion during the massage? A friend of mine has had a similar issue and found that gently dilating the anus helped improve their condition.
Is this really effective?

Niming, 20~29 year old female. Ask Date: 2015/09/29

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, based on the symptoms, the likelihood of hemorrhoids or anal fissures is the highest.
The so-called anal massage can actually be done with warm sitz baths and using a handheld showerhead to rinse the anal area, without necessarily using fingers.
It is recommended to use a rectal suppository.
As for surgery, it should be approached conservatively and not accepted lightly unless absolutely necessary.
Sincerely, Dr.
Chi-Feng Chen, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2015/09/29

More Info

Managing anal stricture and fissures can be a challenging experience, especially when it involves pain and discomfort during bowel movements. Your situation, characterized by pain, bleeding, and a diagnosis of anal fissures along with a slight stricture, requires careful management to alleviate symptoms and promote healing.

Home Remedies and Management Strategies
1. Warm Sitz Baths: One of the most effective home remedies for anal fissures is taking warm sitz baths. Soaking the anal area in warm water for about 10-15 minutes several times a day can help relax the muscles, increase blood flow to the area, and promote healing. This method is particularly beneficial after bowel movements.

2. Dietary Adjustments: To prevent straining during bowel movements, it is crucial to maintain a high-fiber diet. Foods rich in fiber, such as fruits, vegetables, whole grains, and legumes, can help soften the stool and make it easier to pass. Additionally, staying well-hydrated by drinking plenty of water is essential.

3. Topical Treatments: Over-the-counter topical treatments, such as hydrocortisone creams or ointments containing lidocaine, can help reduce inflammation and provide pain relief. These can be applied directly to the affected area to soothe discomfort.

4. Gentle Massage and Relaxation Techniques: While the idea of using fingers or a small, soft anal plug for massage may seem appealing, it is essential to approach this method with caution. Gentle external massage around the anal area can help relax the sphincter muscles, but inserting anything into the rectum should be done very carefully. If you choose to use a soft anal plug, ensure it is well-lubricated and that you listen to your body’s signals. If you experience increased pain or discomfort, it is advisable to stop immediately.

5. Laxatives and Stool Softeners: If dietary changes are insufficient, consider using over-the-counter stool softeners or mild laxatives to ease bowel movements. These can help prevent straining, which is crucial for healing fissures.

6. Avoiding Irritants: It is important to avoid irritants such as scented soaps, toilet papers with dyes or fragrances, and other products that may cause irritation to the anal area.

When to Seek Medical Attention
While home remedies can be effective, it is crucial to monitor your symptoms closely. If you experience:
- Persistent or worsening pain
- Increased frequency of bleeding
- Signs of infection (such as fever, increased swelling, or discharge)
- Difficulty passing stool despite home management
You should seek medical attention. A healthcare provider may recommend additional treatments, such as prescription medications, topical nitrates, or even surgical options if conservative measures fail.

Conclusion
In summary, managing anal stricture and fissures effectively involves a combination of home remedies, dietary adjustments, and careful monitoring of symptoms. While gentle massage may provide some relief, it is essential to proceed with caution and prioritize comfort. If symptoms persist or worsen, do not hesitate to consult a healthcare professional for further evaluation and treatment options. Your health and comfort are paramount, and there are many strategies available to help you manage this condition effectively.

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