How to improve anal fissure bleeding?

Internal Medicine

59sec

Will anal fissures cause bleeding?

As the name suggests, an anal fissure is a condition where the anal canal splits open, forming small ulcers. These splits run parallel to the longitudinal axis of the anal canal and are typically spindle-shaped or oval. They often cause severe perianal pain. The classic clinical signs of an anal fissure include pain, bleeding during bowel movements, and constipation. Thus, anal fissures do bleed, characterized by spotting of blood during defecation or blood on tissue after bowel movements. The blood is usually bright red. The amount of bleeding relates to the depth and size of the fissure but generally does not present as heavy or spurting bleeding like with hemorrhoids, and significant bleeding is rare. The bleeding from an anal fissure can also recur periodically. Therefore, it is important to seek timely medical treatment at a hospital to ensure effective therapy and early recovery.

Written by Hu Xiang Dang

Colorectal Surgery Department

2min 20sec

symptoms of anal fissure

What are the symptoms of an anal fissure? The most typical symptoms of an anal fissure are clinically manifested in three aspects: pain, rectal bleeding, and constipation. Firstly, constipation: Many patients with anal fissures generally first exhibit symptoms of constipation. Then, due to the dryness and bulkiness of the stool, the skin around the anus tears, forming an anal fissure. Subsequently, because of anal pain, the patient fears defecation, which over time exacerbates the hardness of the stool. As constipation worsens, it can aggravate the fissure, thereby creating a vicious cycle. The second main symptom is pain, which is not only the most significant symptom of an anal fissure but also potentially the most intensely felt by the patient. The skin around the anus is sensitive, and damage to this skin can cause significant pain. The degree and duration of the pain can also indicate the severity of the fissure. Typically, the pain from an anal fissure is cyclical. It usually occurs during defecation, followed by a few minutes of relief. Then, pain is stimulated by the contraction of the internal anal sphincter, causing sustained spasms of the sphincter, leading to severe pain. This pain can last for several minutes or even hours. During this time, the patient may feel extremely uncomfortable and find it unbearable, some only finding relief when the sphincter muscles relax after fatigue. Then, the pain reoccurs with the next bowel movement, characterized by its cyclic nature. The third main symptom is rectal bleeding. Patients may notice droplets of blood during defecation, sometimes spotting a few drops of bright red blood in the toilet bowl or seeing streaks of blood on the stool, occasionally mixed with intestinal mucus. When wiping the anus, sometimes the toilet paper shows red blood. However, the amount of bleeding is related to the size and depth of the fissure—the larger and deeper the fissure, the more bleeding occurs. Additionally, some patients may experience itching around the anus. The ulcerated surface of the fissure, along with secretions from the anal glands, irritates the skin around the anus, which can lead to perianal eczema and itching.

Written by Chen Tian Jing

Colorectal Surgery

51sec

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.)

Written by Yu Xu Chao

Colorectal Surgery

57sec

How to distinguish between anal fissures and hemorrhoids

To distinguish between anal fissures and hemorrhoids, one can first differentiate based on symptoms. Anal fissures primarily cause pain during defecation and minor bleeding, with the pain typically lasting from 20 minutes to half an hour. Patients often have hard stools or constipation. In contrast, hemorrhoids primarily lead to intermittent painless rectal bleeding. The blood is bright red and usually in greater volume, often appearing in a spraying or dripping pattern after defecation. Some patients may also experience prolapsed hemorrhoids, often accompanied by a sensation of heaviness and foreign body in the anus. Further, through a digital rectal examination, an anal fissure can be identified by a palpable ulcer or crack at the posterior or anterior midline of the anus. Hemorrhoids, being soft venous clusters, can also be differentiated through this examination.

Written by Yu Xu Chao

Colorectal Surgery

1min 13sec

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)

How to improve anal fissure bleeding?

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Will anal fissures cause bleeding?

symptoms of anal fissure

How to improve anal fissure bleeding?

How to distinguish between anal fissures and hemorrhoids

The differences between stages one, two, and three of anal fissures.