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 Chen Tian Jing
Colorectal Surgery
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What should be paid attention to for anal fissures usually?

Patients with anal fissures primarily develop the condition due to a history of dry stools or straining during early bowel movements. Therefore, it is important for patients to ensure smooth bowel movements and avoid excessive dryness of stools. Diet adjustments should include consuming more bland vegetables and fruits, and avoiding spicy foods such as chili peppers, seafood, and mutton, which are irritants. Additionally, ensuring adequate daily water intake is crucial to prevent dryness in the intestinal feces. Besides dietary and bowel adjustments, patients with anal fissures should actively seek medical treatment during acute episodes to prevent the recurrence of early fissures and the formation of chronic fissures. Early-stage fissures may be treated with topical medications to alleviate symptoms, while chronic fissures may require surgical intervention. (Medication should be administered under the guidance of a doctor.)

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Written by Chen Tian Jing
Colorectal Surgery
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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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Written by Yu Xu Chao
Colorectal Surgery
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The differences between stages one, two, and three of anal fissures.

In clinical practice, anal fissures are not categorized into stages one, two, or three; they are primarily classified as either acute or chronic anal fissures. Acute anal fissures, which occur in the early stages of the condition, are characterized by pain during defecation and minor bleeding. For such cases, the pain usually doesn’t last long, and conservative treatment with medication can be chosen. Topical applications such as dragon's pearl ointment or nitroglycerin ointment are generally used. It is also important to keep the anal region dry and clean, perhaps by using anal washes for sitz baths, while ensuring that the stool is soft to maintain smooth bowel movements. Chronic anal fissures, on the other hand, are mainly due to the development of scars on the ulcer surface. This condition involves prolonged pain and may include some narrowing of the anus. In such cases, surgical excision of the fissure may be necessary. Post-surgery treatment may include changing dressings with medications like red oil gauze strips, golden ointment, and anal washes. (Under the guidance of a doctor for medication use)

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Written by Hu Xiang Dang
Colorectal Surgery Department
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What should I do if I have an anal fissure?

So, what should we do if we have an anal fissure? Generally, for patients with early-stage anal fissures where the fissure is still fresh and without complications such as sentinel piles, hypertrophied anal papillae, anal papillitis, anal stenosis, subcutaneous fistulae, or subcutaneous abscesses, conservative treatment under medical supervision can be pursued. First, altering the diet by increasing water intake and consuming more vegetables and fruits can improve the characteristics of the stool. Post bowel movement, traditional Chinese herbal remedies for pain relief, such as Shen Tang, or sitz baths using potassium permanganate solution can be used. Locally, applications like Longzhu Ointment or Jiuhua Ointment may be applied. If constipation is present, stool softeners should be used to aid bowel movements. In the chronic stage, if symptoms are only accompanied by internal sphincter spasm and no other complications such as sentinel piles or hypertrophied anal papillae, in addition to the general treatments mentioned above, anal dilation can be considered. If dilation is ineffective, then surgical treatment should be considered at this time. For patients with chronic anal fissures who also have symptoms like sentinel piles, hypertrophied anal papillae, anal stenosis, or for those who have had prolonged ineffective treatment of initial anal fissures, it is advisable to seek surgical treatment at a hospital.

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Written by Li Xiao Jie
Internal Medicine
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What should not be eaten with anal fissure?

Patients with anal fissures should be cautious with their diet, avoiding spicy and irritating foods to prevent exacerbation. They should also consume foods rich in roughage, such as cornmeal, sweet potatoes, celery, leeks, and cabbage, which can facilitate bowel movements and prevent the aggravation of anal fissures due to dry stools. Additionally, alcohol should be avoided as it may dilate blood vessels and lead to increased bleeding. It is essential for patients with anal fissures to maintain smooth bowel movements and avoid sitting or squatting for extended periods.