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Anal fissure
What is an anal fissure?
What is an anal fissure? In clinical practice, we often encounter patients asking this question. An anal fissure is a crack in the skin around the anal canal; simply put, it is a split in the skin at the anus. The direction of the split aligns with the direction of the anal skin's folds. Of course, not all cracks in the anal skin are called anal fissures. It is only considered an anal fissure if there is a full-thickness split in the skin at the anus. If it is a superficial skin split, it is referred to as an anal skin laceration or fissuring, such as those caused by certain anal itching diseases, which are in fact fissures in the anal skin. Anal fissures commonly occur at the “anterior and posterior midline” of the anus, which is similar to the directions of 6 o'clock and 12 o'clock as described on a clock face. Doctors often describe these as positions at 6 o'clock and 12 o'clock.
What medicine is used for anal fissures?
So, what medications can patients with anal fissures use routinely? If an anal fissure occurs, during the early stages when the fissure is new, we can use ointments such as Dragon Pearl Ointment, Jiu Hua Ointment, Musk Hemorrhoids Ointment, and Ganthai Ointment, which are hemorrhoid ointments that remove decay and promote tissue regeneration, to facilitate the healing of the wound. After defecating, we can use traditional Chinese medicine pain relievers like Shen Soup or a potassium permanganate solution for cleansing. After cleaning, we should also use some hemorrhoid suppositories for insertion into the anus, which can be used 1-2 times daily. Additionally, oral medications should be taken to lubricate the intestines and aid bowel movements. For example, liquid paraffin, hemp seed pills, hemp seed capsules, and polyethylene glycol electrolyte powder (solution), etc., to soften the stool and improve bowel conditions. If there is severe pain during or after bowel movements due to the anal fissure, local anesthesia like ropivacaine can be used at the Changqiang acupoint for a prolonged pain relief, and long-lasting pain relievers can also be injected at the base of the fissure to relieve pain during defecation. Considering the individual differences of patients, the specific medications, dosages, and precautions should be followed. It is crucial for patients to consult a doctor before using any medications to prevent misuse of drugs.
How to treat anal fissures and constipation?
Anal fissures and constipation are generally accompanying symptoms. When the stool is dry, the patient exerts excessive force during defecation, causing the stool to tear the local anal sphincter and mucosa, resulting in an anal fissure. Prolonged and recurrent anal fissures, due to the contraction of the local anal sphincter, can make defecation difficult for patients, or, because of the severe pain during defecation, patients may avoid defecating. This leads to stool remaining in the intestinal lumen for too long, causing the stool to dry out and further inducing constipation. To treat anal fissures and constipation, it is first necessary to lubricate the stool. One can take oral medications for lubricating the intestines and easing bowel movements or use topical lubricants. Treatment can also be complemented with anal dilation therapy or surgery through endoscopic incision, and applying a traditional Chinese medicine hot compress to the local fissure.
What is the best treatment for anal fissures?
The treatment of anal fissures depends on the specific situation. For initial onset anal fissures, since the fissure is small, treatment can be achieved through methods such as Chinese herbal fumigation or topical application of medicine. For recurrent anal fissures that have persisted for a longer time, fumigation and washing with medicine are less effective. In such cases, surgical treatment is necessary, and it should be sought at the proctology department of a formal hospital. Anal fissures are greatly related to bowel habits, so it is important to maintain smooth bowel movements by, for example, drinking more water, eating more high-fiber foods, consuming less spicy and stimulating foods, abstaining from alcohol, and avoiding greasy foods.
How to examine anal fissures in women
If a woman suspects symptoms of an anal fissure, it is recommended to directly perform a digital rectal examination rather than an anoscopy, to avoid worsening the condition by potentially tearing local fissures with the anoscope. Typically, an anal fissure presents with severe local pain in the anus, bleeding during bowel movements, and accompanying hard stools. Therefore, the initial treatment should focus on softening the stool, for which one can take oral hemp seed oil capsules to facilitate bowel movements. Additionally, applying Recovery New liquid as a hot compress on the local fissures can help alleviate symptoms and promote healing. If there is anal constriction, anal dilation therapy might be chosen, or treatment may involve a lateral internal sphincterotomy. (Please use the above medications under the guidance of a physician, and do not use them indiscriminately on your own.)
Is anal fissure serious?
People often ask whether anal fissures are serious and what the consequences might be if they are not treated. Although treating anal fissures is not particularly difficult clinically, many patients, due to a lack of treatment knowledge and awareness of the condition, often delay treatment, which can cause some harm to their health. If an anal fissure is not treated, in addition to the pain during bowel movements and bleeding that the fissure itself causes, over time, it could also lead to conditions such as anal fistula and hypertrophied anal papillae. At the end of the fissure, a sentinel pile may develop. Due to the repeated irritation by fecal matter in an inflamed fissure, a linear ulcer may form. The skin and subcutaneous tissue around the anus might undergo fibrosis, thickening, or. form a hard lump. If the fissure repeatedly becomes infected, it can lead to the development of an anal sinus, and after infection, it may cause subcutaneous fistulas or abscesses. Of course, if an anal fissure persists over time, due to long-term spasm and fibrosis of the internal sphincter, it can lead to consequences such as anal stenosis.
What should be paid attention to usually for anal fissures?
What should I pay attention to for anal fissures? Friends who suffer from anal fissures should note the following: Firstly, pay attention to your diet. Adjust your diet structurally to be diverse. Drink plenty of water and eat less spicy and stimulating food; abstain from alcohol and betel nuts; eat less spicy hot pot and similar foods. Also, maintain a smooth bowel movement. We should develop a habit of defecating regularly, and treat constipation correctly. However, in treating constipation, we should not misuse laxatives and should use medications under the proper guidance of a doctor. We should also pay attention to keeping the anal area clean and hygienic by washing it after each bowel movement. After defecation, it is best to perform sitz baths using salt water, traditional Chinese medicine pain relievers like Shen Tang, or potassium permanganate solution. This helps in the recovery of the anal fissure. In addition to the above, we should also engage in appropriate activities. Friends with anal fissures can perform anal muscle contractions, such as Kegel exercises or stretching exercises.
Can anal fissures be cured completely?
Anal fissures are a curable condition, so do not worry. Anal fissures are relatively common in clinical practice and are a frequently occurring disease. Fresh anal fissures, which are of short duration and have small fissures, can be treated and cured using methods such as fumigation, oral medications, or rectal insertion. For older, chronic anal fissures, surgical treatment can be administered, including methods like the Milligan-Morgan technique or fissurectomy, all of which can achieve a cure. However, anal fissures are related to lifestyle and dietary habits, so even after healing, it is important to be cautious of various triggering factors to prevent recurrence.
What should be paid attention to for anal fissures usually?
Patients with anal fissures primarily develop the condition due to a history of dry stools or straining during early bowel movements. Therefore, it is important for patients to ensure smooth bowel movements and avoid excessive dryness of stools. Diet adjustments should include consuming more bland vegetables and fruits, and avoiding spicy foods such as chili peppers, seafood, and mutton, which are irritants. Additionally, ensuring adequate daily water intake is crucial to prevent dryness in the intestinal feces. Besides dietary and bowel adjustments, patients with anal fissures should actively seek medical treatment during acute episodes to prevent the recurrence of early fissures and the formation of chronic fissures. Early-stage fissures may be treated with topical medications to alleviate symptoms, while chronic fissures may require surgical intervention. (Medication should be administered under the guidance of a doctor.)
How to treat postpartum constipation and anal fissures?
In cases of postpartum constipation, if it becomes severe and leads to an anal fissure, it is necessary to visit the hospital's proctology department for an examination. When an anal fissure occurs, it generally requires the use of medications to invigorate blood and dissolve stasis to facilitate wound healing. You can also apply some grease around the wound to increase the lubrication of the muscles around the anus, which can alleviate some of the difficulties experienced during defecation. In daily life, it is important to drink more water, consume plenty of fresh vegetables and fruits, avoid spicy and irritating foods that can cause internal heat, and you can also use a potassium permanganate solution for sitz baths to alleviate local pain. If the condition of the anal fissure is severe, surgical treatment may be necessary.