What medicine is used for anal fissures?

Written by Hu Xiang Dang
Colorectal Surgery Department
Updated on September 20, 2024
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So, what medications can patients with anal fissures use routinely? If an anal fissure occurs, during the early stages when the fissure is new, we can use ointments such as Dragon Pearl Ointment, Jiu Hua Ointment, Musk Hemorrhoids Ointment, and Ganthai Ointment, which are hemorrhoid ointments that remove decay and promote tissue regeneration, to facilitate the healing of the wound. After defecating, we can use traditional Chinese medicine pain relievers like Shen Soup or a potassium permanganate solution for cleansing. After cleaning, we should also use some hemorrhoid suppositories for insertion into the anus, which can be used 1-2 times daily. Additionally, oral medications should be taken to lubricate the intestines and aid bowel movements. For example, liquid paraffin, hemp seed pills, hemp seed capsules, and polyethylene glycol electrolyte powder (solution), etc., to soften the stool and improve bowel conditions. If there is severe pain during or after bowel movements due to the anal fissure, local anesthesia like ropivacaine can be used at the Changqiang acupoint for a prolonged pain relief, and long-lasting pain relievers can also be injected at the base of the fissure to relieve pain during defecation. Considering the individual differences of patients, the specific medications, dosages, and precautions should be followed. It is crucial for patients to consult a doctor before using any medications to prevent misuse of drugs.

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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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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.

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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 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.

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What is an anal fissure?

What is an anal fissure? In clinical practice, we often encounter patients asking this question. An anal fissure is a crack in the skin around the anal canal; simply put, it is a split in the skin at the anus. The direction of the split aligns with the direction of the anal skin's folds. Of course, not all cracks in the anal skin are called anal fissures. It is only considered an anal fissure if there is a full-thickness split in the skin at the anus. If it is a superficial skin split, it is referred to as an anal skin laceration or fissuring, such as those caused by certain anal itching diseases, which are in fact fissures in the anal skin. Anal fissures commonly occur at the “anterior and posterior midline” of the anus, which is similar to the directions of 6 o'clock and 12 o'clock as described on a clock face. Doctors often describe these as positions at 6 o'clock and 12 o'clock.