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Anal fissure
What should pregnant women do about constipation and anal fissures?
During pregnancy, due to some special reasons, pregnant women are prone to constipation, and severe cases may develop anal fissures, bleeding, and pain. In such cases, it is first necessary to change the diet to a light one, eat more vegetables and fruits, drink more water, and develop good bowel habits. Avoid squatting for long periods. Additionally, enemas can be used to help with bowel movements, and anti-inflammatory ointments can be applied locally to the anal fissure area for disinfection. Using warm water for sitz baths can also relieve the pain from constipation and anal fissures. Routine abdominal and anal massages can alleviate symptoms and promote bowel movements.
Do anal fissures need treatment?
Anal fissures require treatment. If the patient has a very mild case, there is a possibility of self-healing, though this is not very likely. For initial cases, where the fissure is small, one could consider treatment methods such as Chinese herbal fumigation, topical medications, or potassium permanganate sitz baths, all of which can achieve therapeutic effects. If the patient suffers from recurrent long-term episodes, and the fissure is deep, surgical treatment may need to be considered. This condition falls under the category of proctologic diseases. Patients can visit the proctology department where a doctor will examine them and choose an appropriate surgical method. Complete recovery is possible, so there is no need to worry. To prevent this condition, it is important to maintain smooth bowel movements, ensure cleanliness in the affected area, and avoid infections.
symptoms of anal fissure
What are the symptoms of an anal fissure? The most typical symptoms of an anal fissure are clinically manifested in three aspects: pain, rectal bleeding, and constipation. Firstly, constipation: Many patients with anal fissures generally first exhibit symptoms of constipation. Then, due to the dryness and bulkiness of the stool, the skin around the anus tears, forming an anal fissure. Subsequently, because of anal pain, the patient fears defecation, which over time exacerbates the hardness of the stool. As constipation worsens, it can aggravate the fissure, thereby creating a vicious cycle. The second main symptom is pain, which is not only the most significant symptom of an anal fissure but also potentially the most intensely felt by the patient. The skin around the anus is sensitive, and damage to this skin can cause significant pain. The degree and duration of the pain can also indicate the severity of the fissure. Typically, the pain from an anal fissure is cyclical. It usually occurs during defecation, followed by a few minutes of relief. Then, pain is stimulated by the contraction of the internal anal sphincter, causing sustained spasms of the sphincter, leading to severe pain. This pain can last for several minutes or even hours. During this time, the patient may feel extremely uncomfortable and find it unbearable, some only finding relief when the sphincter muscles relax after fatigue. Then, the pain reoccurs with the next bowel movement, characterized by its cyclic nature. The third main symptom is rectal bleeding. Patients may notice droplets of blood during defecation, sometimes spotting a few drops of bright red blood in the toilet bowl or seeing streaks of blood on the stool, occasionally mixed with intestinal mucus. When wiping the anus, sometimes the toilet paper shows red blood. However, the amount of bleeding is related to the size and depth of the fissure—the larger and deeper the fissure, the more bleeding occurs. Additionally, some patients may experience itching around the anus. The ulcerated surface of the fissure, along with secretions from the anal glands, irritates the skin around the anus, which can lead to perianal eczema and itching.
What should not be eaten with anal fissure?
Patients with anal fissures should be cautious with their diet, avoiding spicy and irritating foods to prevent exacerbation. They should also consume foods rich in roughage, such as cornmeal, sweet potatoes, celery, leeks, and cabbage, which can facilitate bowel movements and prevent the aggravation of anal fissures due to dry stools. Additionally, alcohol should be avoided as it may dilate blood vessels and lead to increased bleeding. It is essential for patients with anal fissures to maintain smooth bowel movements and avoid sitting or squatting for extended periods.
What is the best treatment for anal fissures?
How should an anal fissure be treated? It can be addressed from several aspects. First, let's talk about general treatment. What is the principle of our treatment? It is to relieve pain after bowel movements and gradually promote the healing of the fissure. However, the first step is to relieve the spasm of the sphincter, then facilitate bowel movements to interrupt the vicious cycle. But what specific measures are there? One is to take a sitz bath with traditional Chinese medicine for pain relief, such as "Shen Soup," and a 1:5000 potassium permanganate solution after defecation, maintaining local cleanliness. Then, by orally taking some laxatives or paraffin oil, feces can be softened and lubricated. Alternatively, by increasing water intake and eating more fiber-rich foods, constipation can be corrected to keep the bowels clear. In more severe cases, such as those with sphincter spasms, we can perform anal dilation under local anesthesia. By dilating the anus, the spasm of the sphincter can be relieved, and the healing of the fissure can also be promoted. However, this method has a relatively high recurrence rate, and there may also be complications such as severe bleeding, perianal abscess, and fecal incontinence. Anal dilation should be treated by a doctor, and patients should not blindly use it themselves. Of course, there is also surgical treatment. Once an anal fissure has reached a certain degree, generally a chronic anal fissure, many patients need to undergo surgical treatment. Naturally, there are several surgical methods available. We choose different surgical methods according to the condition and severity of the anal fissure. For example, if the patient has an anal fissure that presents with sentinel piles and hypertrophic anal papillae, but there is no anal stricture or internal sphincter spasm, a simple excision of the fissure can be performed. This involves removing the pathological tissue of the fissure, excising the infective anal sinus along with the hypertrophic anal papillae and sentinel piles, allowing the fissure wound to drain openly. However, if there is associated anal stricture, or there is an internal sphincter spasm, we also need to perform an internal sphincterotomy.
What should I do if anal fissures keep recurring?
Repeated episodes of anal fissure generally result in the formation of chronic anal fissures. The fissure in chronic anal fissures mainly presents as an ulcer surface, and because the fissure is enclosed within the local sphincter muscles, drainage is poor, thus reducing the likelihood of healing. When patients with anal fissures suffer from long-term recurrent episodes, they also experience spasms of the local anal sphincter and tightening of the anal canal, which can lead to difficulties in bowel movements and dry stools in the anal region. When the spasm of the local anal sphincter worsens, the pain may cause patients to be afraid of defecating voluntarily, thereby creating a vicious cycle of recurrent episodes. The best treatment for recurrent chronic anal fissures is surgical intervention.
Can diarrhea cause anal fissures?
Diarrhea may cause anal fissures. An anal fissure refers to a full-thickness vertical tear in the skin of the anal canal below the dentate line, forming an ischemic ulcer. It is commonly found in young and middle-aged adults, and the exact mechanism of its development is not very clear. It is mainly related to local muscle spasms and infection following injury. The main symptoms include severe, sharp pain during and after bowel movements, along with occasional light, bright red bleeding. There may also be constipation and anal discharge. If the skin of the anal canal is chronically irritated by prolonged diarrhea, causing skin damage, it is very likely to lead to an anal fissure.
What should be paid attention to for anal fissures?
The occurrence of anal fissures is highly related to constipation. Therefore, for patients with anal fissures, treating and preventing constipation is the most important approach. It is advisable to eat more vegetables and fruits, consume fewer spicy and stimulating foods, and reduce the intake of greasy foods. The diet should be light, drink more water, and pay attention to local hygiene. Furthermore, patients with anal fissures should avoid sitting or squatting for long periods to prevent aggravating the condition. If symptoms such as fever, difficulty defecating, or severe pain around the anus occur, it is crucial to visit a hospital for examination to rule out other conditions. Regular participation in physical exercise is recommended to promote intestinal movement and facilitate defecation.