What should I do if I have anal fissure bleeding?

Written by Wang Ji Zhong

Internal Medicine

Updated on April 23, 2025

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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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Written by Li Xiao Jie

Internal Medicine

1min 3sec

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Do anal fissures need treatment?

Anal fissures require treatment. If the patient has a very mild case, there is a possibility of self-healing, though this is not very likely. For initial cases, where the fissure is small, one could consider treatment methods such as Chinese herbal fumigation, topical medications, or potassium permanganate sitz baths, all of which can achieve therapeutic effects. If the patient suffers from recurrent long-term episodes, and the fissure is deep, surgical treatment may need to be considered. This condition falls under the category of proctologic diseases. Patients can visit the proctology department where a doctor will examine them and choose an appropriate surgical method. Complete recovery is possible, so there is no need to worry. To prevent this condition, it is important to maintain smooth bowel movements, ensure cleanliness in the affected area, and avoid infections.

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Written by Hu Xiang Dang

Colorectal Surgery Department

1min 1sec

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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.

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Written by Hu Xiang Dang

Colorectal Surgery Department

2min 23sec

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What is the best treatment for anal fissures?

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.

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Written by Chen Tian Jing

Colorectal Surgery

1min 2sec

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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 Deng Heng

Colorectal Surgery

38sec

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How long does it take to recover from an anal fissurectomy?

Anal fissure refers to a small ulcer formed by the skin cracking below the dentate line of the anal canal, with the main symptoms being pain and bleeding. Anal fissure excision surgery is one of the surgical treatments for anal fissures. It mainly involves removing the anal fissure, the sentinel piles, and the hypertrophied anal papillae. It also involves cutting a part of the internal and external sphincter's subcutaneous section. The wound is left open for drainage. A disadvantage is that healing is relatively slow, so it generally takes over a month to fully recover after the surgery.