What is the best treatment for anal fissures?

Written by Hu Xiang Dang
Colorectal Surgery Department
Updated on September 09, 2024
00:00
00:00

How should an anal fissure be treated? It can be addressed from several aspects. First, let's talk about general treatment. What is the principle of our treatment? It is to relieve pain after bowel movements and gradually promote the healing of the fissure. However, the first step is to relieve the spasm of the sphincter, then facilitate bowel movements to interrupt the vicious cycle. But what specific measures are there? One is to take a sitz bath with traditional Chinese medicine for pain relief, such as "Shen Soup," and a 1:5000 potassium permanganate solution after defecation, maintaining local cleanliness. Then, by orally taking some laxatives or paraffin oil, feces can be softened and lubricated. Alternatively, by increasing water intake and eating more fiber-rich foods, constipation can be corrected to keep the bowels clear. In more severe cases, such as those with sphincter spasms, we can perform anal dilation under local anesthesia. By dilating the anus, the spasm of the sphincter can be relieved, and the healing of the fissure can also be promoted. However, this method has a relatively high recurrence rate, and there may also be complications such as severe bleeding, perianal abscess, and fecal incontinence. Anal dilation should be treated by a doctor, and patients should not blindly use it themselves. Of course, there is also surgical treatment. Once an anal fissure has reached a certain degree, generally a chronic anal fissure, many patients need to undergo surgical treatment. Naturally, there are several surgical methods available. We choose different surgical methods according to the condition and severity of the anal fissure. For example, if the patient has an anal fissure that presents with sentinel piles and hypertrophic anal papillae, but there is no anal stricture or internal sphincter spasm, a simple excision of the fissure can be performed. This involves removing the pathological tissue of the fissure, excising the infective anal sinus along with the hypertrophic anal papillae and sentinel piles, allowing the fissure wound to drain openly. However, if there is associated anal stricture, or there is an internal sphincter spasm, we also need to perform an internal sphincterotomy.

Other Voices

doctor image
home-news-image
Written by Yu Xu Chao
Colorectal Surgery
57sec home-news-image

How to distinguish between anal fissures and hemorrhoids

To distinguish between anal fissures and hemorrhoids, one can first differentiate based on symptoms. Anal fissures primarily cause pain during defecation and minor bleeding, with the pain typically lasting from 20 minutes to half an hour. Patients often have hard stools or constipation. In contrast, hemorrhoids primarily lead to intermittent painless rectal bleeding. The blood is bright red and usually in greater volume, often appearing in a spraying or dripping pattern after defecation. Some patients may also experience prolapsed hemorrhoids, often accompanied by a sensation of heaviness and foreign body in the anus. Further, through a digital rectal examination, an anal fissure can be identified by a palpable ulcer or crack at the posterior or anterior midline of the anus. Hemorrhoids, being soft venous clusters, can also be differentiated through this examination.

doctor image
home-news-image
Written by Du Rui Xia
Obstetrics
58sec home-news-image

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.

doctor image
home-news-image
Written by Deng Heng
Colorectal Surgery
45sec home-news-image

What department should I go to for an anal fissure?

Anal fissures should of course be treated by proctology specialists, as anal fissures are a common condition in proctology. They are small ulcers that form in the skin of the anal canal below the dentate line after it has been injured. The primary symptom is anal pain, characterized by periodic, tearing-like pain. The second symptom is rectal bleeding during bowel movements caused by wounds on the fissure. The third symptom is that due to the pain, patients might avoid defecating, leading to habitual constipation. Therefore, proctologists have a comprehensive understanding and good knowledge reserve about anal fissures, so it is recommended that patients with this condition consult the proctology department.

doctor image
home-news-image
Written by Lin Shao Qiang
Internal Medicine
54sec home-news-image

What fruits to eat for anal fissures?

With anal fissures, it is important to maintain smooth bowel movements. Consume more fresh fruits and vegetables, such as bananas, kiwis, strawberries, celery, and spinach, as their rough fibers help lubricate the intestines and facilitate bowel movements. Avoid spicy and irritating foods, foods that cause internal heat, especially avoid chili peppers, onions, ginger, and garlic, and do not drink alcohol, as these can exacerbate constipation and worsen symptoms of anal fissures. Additionally, keep the affected area dry and clean to prevent bacterial infection, and wash with warm water. If there is inflammation in the area of the anal fissure, a sitz bath with potassium permanganate can be used.

doctor image
home-news-image
Written by Wang Hui Jie
Gastroenterology
51sec home-news-image

Can diarrhea cause anal fissures?

Diarrhea may cause anal fissures. An anal fissure refers to a full-thickness vertical tear in the skin of the anal canal below the dentate line, forming an ischemic ulcer. It is commonly found in young and middle-aged adults, and the exact mechanism of its development is not very clear. It is mainly related to local muscle spasms and infection following injury. The main symptoms include severe, sharp pain during and after bowel movements, along with occasional light, bright red bleeding. There may also be constipation and anal discharge. If the skin of the anal canal is chronically irritated by prolonged diarrhea, causing skin damage, it is very likely to lead to an anal fissure.