Can diarrhea cause anal fissures?

Written by Wang Hui Jie
Gastroenterology
Updated on September 04, 2024
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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.

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Written by Hu Xiang Dang
Colorectal Surgery Department
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What medicine is used for anal fissures?

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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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.

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Deng Heng
Colorectal Surgery
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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.

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Written by Li Xiao Jie
Internal Medicine
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What should be paid attention to for anal fissures?

The occurrence of anal fissures is highly related to constipation. Therefore, for patients with anal fissures, treating and preventing constipation is the most important approach. It is advisable to eat more vegetables and fruits, consume fewer spicy and stimulating foods, and reduce the intake of greasy foods. The diet should be light, drink more water, and pay attention to local hygiene. Furthermore, patients with anal fissures should avoid sitting or squatting for long periods to prevent aggravating the condition. If symptoms such as fever, difficulty defecating, or severe pain around the anus occur, it is crucial to visit a hospital for examination to rule out other conditions. Regular participation in physical exercise is recommended to promote intestinal movement and facilitate defecation.