What should I do about anal bleeding and anal fissures?

Written by Chen Tian Jing
Colorectal Surgery
Updated on October 27, 2024
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If a fissure is visible to the naked eye at the anal sphincter during a digital rectal examination, it is primarily considered an anal fissure. Anal fissures generally cause severe local pain and bleeding from the fissure. The fissure is primarily due to the local crack being stretched or opened, causing bleeding from small blood vessels, and the blood from the fissure is usually bright red. To treat bleeding from an anal fissure, it is first necessary to soften the stool, as the occurrence of an anal fissure is mainly related to dry stools and difficulty defecating. Once the stool is lubricated, it can reduce the need to exert excessive force during defecation, lowering the possibility of stretching the local fissure. Topical application of hemorrhoid cream at the fissure, or combined with oral medications that cool the blood and stop bleeding, may be used. If there is repeated bleeding from an anal fissure, surgical treatment is also recommended. (Please use medications under the guidance of a professional physician, and do not self-medicate.)

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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.

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Characteristics of anal fissure with bleeding

An anal fissure is a small ulcer formed by the full-thickness splitting of the skin of the anal canal below the dentate line. A characteristic of bleeding due to an anal fissure is that it generally occurs along with periodic, tearing-like pain. Thus, bleeding and pain are the main clinical manifestations of an anal fissure. During defecation, the damaged surface can lead to bleeding from the fissure, usually with a small amount of blood. The stool may have streaks of blood, or there might be a few drops of fresh blood after defecation, or a slight smearing of fresh blood on toilet paper during wiping.

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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.)

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What should I do about anal bleeding and anal fissures?

If a fissure is visible to the naked eye at the anal sphincter during a digital rectal examination, it is primarily considered an anal fissure. Anal fissures generally cause severe local pain and bleeding from the fissure. The fissure is primarily due to the local crack being stretched or opened, causing bleeding from small blood vessels, and the blood from the fissure is usually bright red. To treat bleeding from an anal fissure, it is first necessary to soften the stool, as the occurrence of an anal fissure is mainly related to dry stools and difficulty defecating. Once the stool is lubricated, it can reduce the need to exert excessive force during defecation, lowering the possibility of stretching the local fissure. Topical application of hemorrhoid cream at the fissure, or combined with oral medications that cool the blood and stop bleeding, may be used. If there is repeated bleeding from an anal fissure, surgical treatment is also recommended. (Please use medications under the guidance of a professional physician, and do not self-medicate.)

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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.