What is the best treatment for a minor anal fissure?

Written by Yu Xu Chao
Colorectal Surgery
Updated on October 25, 2024
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Minor anal fissures, which are early-stage fissures, mainly manifest as pain during defecation and minor bleeding, but the pain does not last long and is primarily associated with defecation. For minor fissures, it is generally recommended to choose conservative treatment with medications and dietary regulation to ensure smooth bowel movements. Typically, after defecation, one can choose to use an anal cleansing solution or a potassium permanganate solution for a sitz bath. After the sitz bath, apply Dragon Ball ointment or nitroglycerin ointment locally to promote the healing of the ulcerated surface. At the same time, in terms of diet, one should drink more water and consume foods rich in dietary fiber to maintain smooth bowel movements as much as possible, avoiding dry and hard stools, which also helps in the healing of minor anal fissures. Additionally, patients should pay attention to keeping the anal area dry and clean, avoid irritating the wound, and prevent infection that could exacerbate the condition.

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Written by Li Xiao Jie
Internal Medicine
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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.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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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.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days can an anal fissure heal?

Mild anal fissures or those with shallow cracks can generally heal within about a week through local heat application or by applying hemorrhoid cream. However, there is another type of anal fissure known as chronic anal fissure. Chronic anal fissures primarily involve ulcer-like infectious changes at the local site, hence, they cannot heal on their own and can only be alleviated by lubricating the stools and applying hemorrhoid cream locally. In some cases, conservative treatment might not be significantly effective for chronic anal fissures. If surgery is performed, the recovery time is approximately 20 days. It is recommended that patients with chronic anal fissures undergo surgical treatment with endoscopic loosening.

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Written by Du Rui Xia
Obstetrics
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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.