How to treat hemorrhoids, bloody stool, and anal fissures?

Written by Xu Jun Hui
General Surgery
Updated on February 16, 2025
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Hemorrhoids and anal fissures are two different conditions. Generally, the early treatment for anal fissures is similar to that for early hemorrhoids, which is conservative treatment. This includes ensuring smooth bowel movements, preventing constipation, avoiding dry stools, preventing prolonged bowel movements, and avoiding sitting still for long periods. If the amount of bleeding is small, conservative treatment as mentioned above, along with the application of local medication around the anus, can control the symptoms. Regularly consume vegetables and dietary fiber. If there is severe bleeding from hemorrhoids or severe pain due to a large fissure in anal fissures, relevant examinations should be conducted. After ruling out other conditions, surgery may be necessary.

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Written by Chen Tian Jing
Colorectal Surgery
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How to improve anal fissure bleeding?

To improve anal fissure and bleeding, the first step is to treat constipation by softening the stool, as most anal fissures are caused by dry stools tearing the local skin and mucous membranes of the anus, leading to bleeding from these tears. For those experiencing pain and bleeding due to anal fissures, it is advisable to apply sesame oil around the anus before each bowel movement to prevent irritations from stool aggravating the fissure, which can cause recurrent pain and bleeding. After defecation, hemorrhoid cream can be applied for hemostatic treatment, and medicinal herbal solutions can be used for local compression and hot compresses to promote the growth and healing of the fissure. (Note: Medications should be used under the guidance of a doctor.)

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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 Wang Hui Jie
Gastroenterology
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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.

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Written by Lin Shao Qiang
Internal Medicine
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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.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days can an anal fissure heal?

Mild anal fissures or those with shallow cracks can generally heal within about a week through local heat application or by applying hemorrhoid cream. However, there is another type of anal fissure known as chronic anal fissure. Chronic anal fissures primarily involve ulcer-like infectious changes at the local site, hence, they cannot heal on their own and can only be alleviated by lubricating the stools and applying hemorrhoid cream locally. In some cases, conservative treatment might not be significantly effective for chronic anal fissures. If surgery is performed, the recovery time is approximately 20 days. It is recommended that patients with chronic anal fissures undergo surgical treatment with endoscopic loosening.