How to treat anal fissure bleeding

Written by Yu Xu Chao
Colorectal Surgery
Updated on May 21, 2025
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For early anal fissure bleeding, the first step is to soften the stool by eating more foods high in rough fiber to maintain smooth bowel movements as much as possible. This prevents hard and dry stools from irritating the fissure, causing bleeding or worsening pain. Additionally, after defecating, it is necessary to take a sitz bath using warm saltwater or an anal cleansing solution. It is generally recommended to sitz bath for five to six minutes, which can have anti-inflammatory and hemostatic effects. After the sitz bath, apply Dragon Ball ointment or nitroglycerin ointment locally to promote ulcer healing. Typically, symptoms can significantly improve within seven to ten days of medication. However, if the patient has chronic anal fissure with prolonged pain after each bowel movement, surgical treatment is needed due to fibrous scar formation in the internal anal sphincter. In such cases, an anal fissure excision surgery might be undertaken, followed by dressing changes using medications like red oil ointment gauze or golden ointment. (Please follow medical advice regarding medication.)

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Written by Deng Heng
Colorectal Surgery
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What foods should be avoided with anal fissures?

People with anal fissures should avoid consuming chili peppers and alcohol. Chili peppers contain a compound called capsaicin, which can strongly irritate the nerves in the gastrointestinal tract and the ulcers of anal fissures, causing severe pain in the affected area. Additionally, capsaicin can dilate the mucosal blood vessels, leading to bleeding in the anal fissures. Alcohol has a similar effect, as it can exacerbate congestion and blood stasis in the anal and rectal areas. In most cases, consuming chili peppers and alcohol can intensify the pain.

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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 Chen Tian Jing
Colorectal Surgery
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What should I do if my anal fissure doesn't heal?

If an anal fissure consistently fails to heal proactively, it may be due to the repeated expansion of the fissure, or recurrent instances of dry stools and bleeding, leading to ulcerative, infectious changes at the local fissure. This can progress into a chronic anal fissure. Chronic anal fissures have larger local wound surfaces, and the patient may also experience excessive tightness in the anal canal. The local fissure, wrapped within the tightened anal canal, does not drain well, making self-healing impossible. To treat chronic anal fissures, or recurrent fissures, it is recommended to perform a lateral internal sphincterotomy and further debride the local fissure to ensure complete healing of the anal fissure.

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Written by Xu Jun Hui
General Surgery
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How to treat hemorrhoids, bloody stool, and anal fissures?

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 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.