Anal Pain: Causes and Remedies for Anal Fissures

I would like to inquire about anal issues!

My anus initially felt like it was injured after passing a hard stool, almost like a cut sensation! After that, I started to feel like there was a wound every time I had a bowel movement.
I went to see a doctor, and they suggested it might be an anal fissure.
Unfortunately, it hasn't healed.
The pain usually occurs after a bowel movement, with significant discomfort and redness in the anal area.
I also experience pain when urinating, as the anal area contracts.
I then purchased a dietary supplement similar to enzymes to help with smoother bowel movements, which has reduced the hardness of my stools and consequently lessened the pain.
I have been enduring this for almost six months.
Initially, the pain after bowel movements was severe, but now that my bowel movements are smoother, the pain has decreased.
However, I still occasionally feel a slight stinging sensation in the anal area, but there is no swelling.
I have also noticed a moist feeling in the anal area, and when I wipe with toilet paper, there is some discharge (this only happens after a bowel movement and lasts for a short while).
Could you please tell me what condition my anus might be experiencing? Thank you!

Songzi, 30~39 year old female. Ask Date: 2016/03/13

Dr. Xu Kaixi reply Surgery

The sharp pain at the anal opening may be due to abrasion or damage to the anal mucosa, with the resulting wound exuding fluid that can cause slight discharge during wiping.
This condition may improve and heal with better bowel habits.

Reply Date: 2016/03/13

More Info

Anal pain, particularly following a hard bowel movement, can often be attributed to anal fissures. An anal fissure is a small tear in the lining of the anus, which can occur due to the passage of hard stools. This condition can lead to significant pain, especially during and after bowel movements, and may also cause symptoms such as bleeding and a sensation of burning or stinging.

From your description, it seems that you initially experienced pain after a hard bowel movement, which is a common trigger for anal fissures. The pain you feel after defecation, along with the redness and swelling, further supports this diagnosis. The presence of a "wet" feeling and discharge after bowel movements could indicate irritation or inflammation in the anal area, which can occur with fissures or other conditions such as infections or hemorrhoids.

Here are some potential causes and remedies for anal fissures:

Causes:
1. Hard Stools: As you've noted, passing hard stools is a primary cause of anal fissures. This can be exacerbated by dehydration or a low-fiber diet.

2. Straining: Excessive straining during bowel movements can increase the risk of developing fissures.

3. Chronic Diarrhea: Frequent loose stools can also irritate the anal area and lead to fissures.

4. Anal Trauma: Any trauma to the anal region, including anal intercourse or the use of certain medical instruments, can cause fissures.

5. Underlying Conditions: Conditions such as inflammatory bowel disease (IBD) or sexually transmitted infections (STIs) can also contribute to anal pain and fissures.

Remedies:
1. Dietary Changes: Increasing fiber intake can help soften stools and make them easier to pass. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated is crucial.

2. Stool Softeners: Over-the-counter stool softeners can help ease bowel movements and reduce straining.

3. Warm Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help soothe the anal area and promote healing.

4. Topical Treatments: Applying topical anesthetics or hydrocortisone creams may provide relief from pain and inflammation.

5. Avoiding Irritants: Avoiding harsh soaps or wipes in the anal area can prevent further irritation.

6. Medical Treatment: If conservative measures fail, a healthcare provider may recommend medications such as nitroglycerin ointment or calcium channel blockers to promote healing by increasing blood flow to the area. In some cases, surgical intervention may be necessary for chronic fissures.

When to Seek Medical Attention:
Given that you have been experiencing symptoms for about six months, it is advisable to consult a healthcare professional if you haven't already. Persistent pain, especially if accompanied by discharge or bleeding, warrants further evaluation to rule out other conditions such as infections, hemorrhoids, or more serious issues.

In summary, while anal fissures are a common cause of anal pain, especially following hard bowel movements, it is essential to address the underlying causes and consider both home remedies and medical treatments. If symptoms persist or worsen, seeking medical advice is crucial for proper diagnosis and management.

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