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Anal fissure
Can anal fissures cause itching?
In most cases, anal fissures do not cause itching. Clinically, anal fissures mainly lead to pain during defecation and minor bleeding, with significant pain during and after defecation, lasting about 10 to 20 minutes. Moreover, patients with later-stage anal fissures often have subcutaneous fistulae and external hemorrhoids. However, in the case of anal itching, the patient might also have anal eczema or perianal condyloma acuminatum, necessitating a visit to the proctology department of a hospital for a digital anal examination and local secretion tests for diagnosis. For early-stage anal fissures, conservative treatment with medications can be chosen, along with maintaining smooth bowel movements to avoid dry and hard stools. In the case of chronic anal fissures, surgical treatment is required.
What department should I go to for an anal fissure?
We have an anal fissure and need to go to the hospital for immediate treatment. But what is an anal fissure? As the name suggests, "anal" refers to the anal canal, and "fissure" means a split. Simply put, an anal fissure is a crack at the end of the rectum, forming a small ulcer, which is commonly referred to as an anal fissure. The main symptom is passing bloody stools, and the bleeding is very painful. If you have this condition, you need to go to the hospital in time for treatment. Treatment options may include conservative management or surgery, depending on the case. You should visit the proctology department at general hospitals if available. If there is no specific proctology department, you can also seek treatment in departments specializing in anorectal disorders or general surgery.
How to distinguish between anal fissures and hemorrhoids
Anal fissures and hemorrhoids can indeed be easily confused in clinical practice. Because both occur in the same area and both present with symptoms of rectal bleeding and pain. However, these are two different diseases with different manifestations. Firstly, their symptoms differ. Anal fissures primarily cause severe pain in the anal area, which can feel like being cut with a knife. Hemorrhoids involve the prolapse of hemorrhoidal tissues, which can be felt with the hand and are more intuitively sensed. Their early signs also differ. Hemorrhoids generally start with bleeding without pain, while anal fissures typically start with pain and occasionally bleeding. In clinical practice, a local examination of the anal area is necessary to differentiate between them. By identifying their differences, a clear diagnosis can be made, and timely treatment can be provided to help patients recover health as soon as possible.
What is the best treatment for anal fissure polyps?
In medical terms, an anal tag is known as a sentinel pile, which is simply a common external hemorrhoid. It results from prolonged non-healing anal fissures and repeated local inflammatory irritation, leading to tissue hyperplasia. The only way to remove the anal tag is through surgical removal, as medications alone cannot cure it. It is advisable to maintain a light diet, drink plenty of water, and consume lots of vegetables and fruits to keep bowel movements regular and soft, which can help reduce the occurrence of anal fissures. During flare-ups, one should avoid consuming beef, lamb, seafood, and other potentially irritating foods, and avoid prolonged sitting or standing. If stools are dry, products such as hemp seed pills, lactulose oral solution, and polyethylene glycol 4000 can be used to effectively soften the stools and alleviate symptoms of anal fissures. (Please use medications under the guidance of a doctor.)
How does an anal fissure form?
The formation of anal fissures is related to various factors. The first and most common factor is abnormal stool, such as chronic constipation or dry, hard stools, which causes mechanical trauma during defecation. This is the direct cause of most anal fissures. Another cause is due to spasms of the internal anal sphincter and inflammatory stimulation of the intestines, anal canal, and anal sinuses. Some acidic stools also stimulate the sphincter, leading to increased tension in the internal anal sphincter, and can cause a noticeable increase in resting pressure in the anal canal. If the anal flexibility is insufficient, the passage of dry, hard stool can lead to fissures. Lastly, since the anal canal and the rectum are at an angle to each other, the thick wall of the anal canal bears the greatest pressure during defecation, which is why fissures often occur on the posterior midline of the anal canal.
What should I do if I have hemorrhoids bleeding and anal fissures?
Hemorrhoids can lead to local bleeding, and anal fissures can similarly cause bleeding in the local anal area during bowel movements. Therefore, if it is clearly diagnosed as hemorrhoids combined with an anal fissure, and the patient is experiencing bleeding, it is necessary to carry out hemostatic treatment as soon as possible to avoid further exacerbation of bleeding, which may lead to symptoms of anemia in the patient. Both hemorrhoids and anal fissure bleeding can temporarily be managed with oral hemostatic drugs. If the hemorrhoidal bleeding is more severe, direct ligation of the hemorrhoids can be performed. Bleeding from an anal fissure mainly manifests as bleeding from a local fissure, primarily caused by dry stools, so patients with an anal fissure who experience bleeding must receive treatment that softens the stool and facilitates bowel movements. If both hemorrhoids and anal fissures are present and recur frequently, and conservative medication does not easily heal the condition, a mixed hemorrhoidectomy which includes an external peeling and internal ligation surgery combined with a lateral internal sphincterotomy can be performed. (Note: This answer is for reference only. Medication should be taken under the guidance of a professional physician, and one should not medicate blindly.)
Will anal fissures cause bleeding?
As the name suggests, an anal fissure is a condition where the anal canal splits open, forming small ulcers. These splits run parallel to the longitudinal axis of the anal canal and are typically spindle-shaped or oval. They often cause severe perianal pain. The classic clinical signs of an anal fissure include pain, bleeding during bowel movements, and constipation. Thus, anal fissures do bleed, characterized by spotting of blood during defecation or blood on tissue after bowel movements. The blood is usually bright red. The amount of bleeding relates to the depth and size of the fissure but generally does not present as heavy or spurting bleeding like with hemorrhoids, and significant bleeding is rare. The bleeding from an anal fissure can also recur periodically. Therefore, it is important to seek timely medical treatment at a hospital to ensure effective therapy and early recovery.
How to cure anal fissure bleeding
Anal fissures are a common anorectal disorder, primarily characterized by the formation of small ulcers due to skin lacerations below the dentate line. The main symptoms are bleeding and pain during defecation. Generally, the amount of bleeding is small, noticeable on toilet paper or with a trace of blood on stools. The primary principle of treatment is to address the spasms of the internal sphincter to facilitate the healing of the wound. Common treatment methods include anal dilation and surgical excision, with the overall objective being to alleviate sphincter spasms and promote wound healing. Only when the issue of the anal fissure is resolved will the bleeding gradually alleviate.
How to treat anal fissure bleeding
For early anal fissure bleeding, the first step is to soften the stool by eating more foods high in rough fiber to maintain smooth bowel movements as much as possible. This prevents hard and dry stools from irritating the fissure, causing bleeding or worsening pain. Additionally, after defecating, it is necessary to take a sitz bath using warm saltwater or an anal cleansing solution. It is generally recommended to sitz bath for five to six minutes, which can have anti-inflammatory and hemostatic effects. After the sitz bath, apply Dragon Ball ointment or nitroglycerin ointment locally to promote ulcer healing. Typically, symptoms can significantly improve within seven to ten days of medication. However, if the patient has chronic anal fissure with prolonged pain after each bowel movement, surgical treatment is needed due to fibrous scar formation in the internal anal sphincter. In such cases, an anal fissure excision surgery might be undertaken, followed by dressing changes using medications like red oil ointment gauze or golden ointment. (Please follow medical advice regarding medication.)
Anal fissure: hot compress or cold compress?
During the acute phase of an anal fissure, patients can choose either hot or cold compresses. The clinical symptoms suitable for hot and cold therapy differ. Hot compresses primarily involve the use of herbal washes, where heat helps the medicated solution penetrate the local fissure, promoting healing and contraction of the mucous membrane. The principle behind cold compresses is that, during the acute phase, when the local fissure pain is particularly intense, cold compresses can reduce or alleviate the pain. Besides conservative hot or cold compress treatments, surgery can also be an option after repeated occurrences. The surgical method typically involves an endoscopic loosening procedure. (Use of specific medications should be under the guidance of a doctor.)