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Anal fissure
What should I do if my anal fissure doesn't heal?
If an anal fissure consistently fails to heal proactively, it may be due to the repeated expansion of the fissure, or recurrent instances of dry stools and bleeding, leading to ulcerative, infectious changes at the local fissure. This can progress into a chronic anal fissure. Chronic anal fissures have larger local wound surfaces, and the patient may also experience excessive tightness in the anal canal. The local fissure, wrapped within the tightened anal canal, does not drain well, making self-healing impossible. To treat chronic anal fissures, or recurrent fissures, it is recommended to perform a lateral internal sphincterotomy and further debride the local fissure to ensure complete healing of the anal fissure.
What should I do if I have anal fissure bleeding?
The main symptoms of patients with anal fissures are bleeding and pain. Extended periods of bleeding can first lead to local infections and secondly to systemic anemia, thus immediate and timely treatment is necessary. Firstly, maintaining good personal hygiene is crucial; this includes daily cleaning of the anal area and using hot sitz baths to help improve venous circulation. Secondly, it's important to drink plenty of water, eat fresh vegetables and fruits, avoid spicy foods, and ensure regular bowel movements. In this situation, topical medications can be used. Treatment with suppositories that invigorate the blood and reduce stagnation can have a local anti-inflammatory effect. If medication does not sufficiently resolve the issue, surgical treatment options such as internal anal sphincterotomy or anal fissurectomy can be considered, which can provide a complete cure.
Can a colonoscopy be performed with an anal fissure?
Patients with anal fissures are advised not to undergo colonoscopy, primarily because the procedure involves inserting the colonoscope through the anus, and anal fissures typically occur within the local sphincter muscles. The passage, or repeated movement, of the probe can cause local fissures to experience painful stimulation, or even worsen the symptoms of the fissures, increasing the likelihood of pain and bleeding for the patient afterwards. Therefore, if patients with anal fissures wish to undergo colonoscopy, they should first receive appropriate medical treatment and wait for the local fissures to heal or be completely cured before undergoing the procedure. If a colonoscopy is necessary, a lubricant can also be applied to the anal region to reduce the irritation of the colonoscope on local fissures.
How long does it take to recover from an anal fissurectomy?
Anal fissure refers to a small ulcer formed by the skin cracking below the dentate line of the anal canal, with the main symptoms being pain and bleeding. Anal fissure excision surgery is one of the surgical treatments for anal fissures. It mainly involves removing the anal fissure, the sentinel piles, and the hypertrophied anal papillae. It also involves cutting a part of the internal and external sphincter's subcutaneous section. The wound is left open for drainage. A disadvantage is that healing is relatively slow, so it generally takes over a month to fully recover after the surgery.
Is anal fissure prone to recurrence?
Anal fissures are prone to recurrence, and the main reasons for recurrence are prolonged sitting or standing, leading to relaxation of the intestinal muscles and insufficient motility, which can cause constipation. During bowel movements, the damaged area can be scratched, resulting in anal fissures. Due to excessive strain, mental stress, and physical fatigue, metabolism can be affected, leading to indigestion and constipation, which can cause anal fissures. Sometimes irregular eating habits and consuming spicy, greasy, and irritating foods can cause constipation, thus aggravating the fissure and leading to its recurrence. An imbalance in intestinal flora can impair digestion and cause constipation, leading to anal fissures. The fundamental treatment for anal fissures is surgical intervention.
Do postpartum anal fissures require surgery?
For postpartum women who experience anal fissures, whether or not they can undergo surgical treatment requires a specific examination to determine the severity of the fissure, and then select a targeted treatment. For mild anal fissures, treatment can be administered through medications, which involves applying topical medications, as well as cleaning the affected area in daily life, which can gradually aid in the recovery of the fissure. It is not the case that all anal fissures must be cured through surgery. However, for some severe anal fissures that are also accompanied by serious infections, this situation necessitates dealing with the affected tissues before the anal fissure can be healed.
Postpartum anal fissure
Postpartum anal fissures are a common symptom during natural childbirth. They occur when there is a tear in the anal area during the delivery of a child. This condition mainly leads to pain in the anal region for women after giving birth, especially during bowel movements. When dealing with postpartum anal fissures, it is important to maintain cleanliness and hygiene in the affected area. Each evening, washing with warm water or a potassium permanganate solution, which has cleansing and anti-inflammatory properties, can effectively alleviate pain in the anal area. Additionally, it is beneficial to consume foods that facilitate bowel movements, such as fresh vegetables and fruits that are rich in dietary fiber, as they can effectively promote gastrointestinal motility and improve constipation.
The main causes of anal fissures
The main causes of anal fissure formation may be related to the following factors: long-term constipation and hard stools, which cause mechanical damage during defecation as the direct cause for most anal fissures. It is also related to anatomical defects. Due to the superficial layer of the external sphincter forming a weak area at the back of the anal canal, dry stools exert the greatest pressure on the weak area at the back of the anus, making it prone to tearing injuries. Additionally, infection of the anal sinuses can lead to inflammation of the anal canal, and spasms of the sphincter losing its soft characteristics is also a reason for the formation of anal fissures. Furthermore, hard and dry fecal masses passing through the anal canal can easily cause tearing injuries, possibly due to the smaller size of the patient's anus.
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.
How to treat hemorrhoids, bloody stool, and anal fissures?
Hemorrhoids and anal fissures are two different conditions. Generally, the early treatment for anal fissures is similar to that for early hemorrhoids, which is conservative treatment. This includes ensuring smooth bowel movements, preventing constipation, avoiding dry stools, preventing prolonged bowel movements, and avoiding sitting still for long periods. If the amount of bleeding is small, conservative treatment as mentioned above, along with the application of local medication around the anus, can control the symptoms. Regularly consume vegetables and dietary fiber. If there is severe bleeding from hemorrhoids or severe pain due to a large fissure in anal fissures, relevant examinations should be conducted. After ruling out other conditions, surgery may be necessary.