Is anal fissure serious?

Written by Hu Xiang Dang
Colorectal Surgery Department
Updated on September 17, 2024
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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.

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Written by Yu Xu Chao
Colorectal Surgery
1min 5sec home-news-image

Can you have intercourse during an anal fissure?

During an anal fissure, it is possible to have sexual intercourse without any impact on the fissure itself. For patients with an anal fissure, the main focus should be on maintaining smooth bowel movements and avoiding dry and hard stools to prevent irritating the wound, which can cause pain and bleeding. It is also important to avoid diarrhea, as frequent bowel movements can irritate the wound over time and worsen the fissure. Clinically, for early-stage anal fissures, conservative treatment with medications is often recommended, along with softening the stool. Commonly used medications include Dragon Balm ointment or nitroglycerin ointment. After defecation, patients can opt to use an anal wash or a potassium permanganate solution for sitz baths. However, for chronic anal fissures, it is generally advised to undergo fissure excision surgery as soon as possible, followed by regular dressing changes to promote healing of the wound. If an anal fissure is left untreated for a long time, it can lead to slight narrowing of the anal canal, which requires significant attention.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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What should I do if I have an anal fissure?

So, what should we do if we have an anal fissure? Generally, for patients with early-stage anal fissures where the fissure is still fresh and without complications such as sentinel piles, hypertrophied anal papillae, anal papillitis, anal stenosis, subcutaneous fistulae, or subcutaneous abscesses, conservative treatment under medical supervision can be pursued. First, altering the diet by increasing water intake and consuming more vegetables and fruits can improve the characteristics of the stool. Post bowel movement, traditional Chinese herbal remedies for pain relief, such as Shen Tang, or sitz baths using potassium permanganate solution can be used. Locally, applications like Longzhu Ointment or Jiuhua Ointment may be applied. If constipation is present, stool softeners should be used to aid bowel movements. In the chronic stage, if symptoms are only accompanied by internal sphincter spasm and no other complications such as sentinel piles or hypertrophied anal papillae, in addition to the general treatments mentioned above, anal dilation can be considered. If dilation is ineffective, then surgical treatment should be considered at this time. For patients with chronic anal fissures who also have symptoms like sentinel piles, hypertrophied anal papillae, anal stenosis, or for those who have had prolonged ineffective treatment of initial anal fissures, it is advisable to seek surgical treatment at a hospital.

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Written by Chen Tian Jing
Colorectal Surgery
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How to improve anal fissure bleeding?

To improve anal fissure and bleeding, the first step is to treat constipation by softening the stool, as most anal fissures are caused by dry stools tearing the local skin and mucous membranes of the anus, leading to bleeding from these tears. For those experiencing pain and bleeding due to anal fissures, it is advisable to apply sesame oil around the anus before each bowel movement to prevent irritations from stool aggravating the fissure, which can cause recurrent pain and bleeding. After defecation, hemorrhoid cream can be applied for hemostatic treatment, and medicinal herbal solutions can be used for local compression and hot compresses to promote the growth and healing of the fissure. (Note: Medications should be used under the guidance of a doctor.)

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Written by Deng Heng
Colorectal Surgery
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What foods should be avoided with anal fissures?

People with anal fissures should avoid consuming chili peppers and alcohol. Chili peppers contain a compound called capsaicin, which can strongly irritate the nerves in the gastrointestinal tract and the ulcers of anal fissures, causing severe pain in the affected area. Additionally, capsaicin can dilate the mucosal blood vessels, leading to bleeding in the anal fissures. Alcohol has a similar effect, as it can exacerbate congestion and blood stasis in the anal and rectal areas. In most cases, consuming chili peppers and alcohol can intensify the pain.

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Written by Chen Tian Jing
Colorectal Surgery
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What causes anal fissures?

Anal fissure is a series of clinical symptoms such as pain or rectal bleeding that occur due to the formation of a crack in the local sphincter muscle of the anus. The main reason for the occurrence of anal fissures is due to poor defecation habits in the early stages of the patient, or excessively dry stools, and excessive force during defecation, causing the local sphincter to burst, resulting in the fissure opening pain or bleeding. To treat anal fissures, it is first necessary to soften the patient's stools and adjust defecation habits. If the patient's diet is poor, it is recommended to maintain a light, easily digestible diet long-term. For those with dry stools, appropriate oral medications to lubricate the intestines and facilitate bowel movements can be used, or sesame oil can be applied around the anus before each defecation to lubricate the stool. If recurrent episodes of anal fissures occur, surgical treatment can also be directly performed. (Medication use should be under the guidance of a doctor.)