How to treat an anal tear in a 26-year-old woman?

Question

Hello doctor,

A 26-year-old woman has experienced an anal tear. She has symptoms of burning, tearing, and pain during and after bowel movements, with a history of constipation and passing hard stools. The duration has been 20 days, and no bleeding is noted. It affects her daily activities, including sitting, working, and sleeping. This is the first occurrence, with no similar past episodes. Her additional concerns include how to heal the tear and prevent infection.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

It sounds like it is an acute anal fissure, which is a small tear in the lining of the anal canal, usually caused by passing hard or large stools. The symptoms you describe, like burning, tearing, and pain during and after bowel movements, are typical. Although there is no bleeding, even a small amount of bleeding may sometimes be present with fissures. Since this is the first occurrence and has lasted about twenty days, it is considered an acute fissure rather than a chronic one.

Healing and management primarily focus on relieving pain, promoting healing, and preventing infection. First-line measures include ensuring soft stools through increased fiber intake (fruits, vegetables, and whole grains) and adequate hydration, and using stool softeners if necessary.

Warm sitz baths for ten to fifteen minutes several times a day, especially after bowel movements, can reduce pain and improve blood flow to the area to promote healing. Topical measures like Lidocaine ointment may relieve pain, and in some cases, Nitroglycerin or calcium channel blocker creams are prescribed to relax the anal sphincter and improve healing. Maintaining strict anal hygiene and gently cleaning the area after bowel movements can help prevent infection.

It is important to avoid straining during defecation, which can worsen the tear. Most acute fissures heal within a few weeks with conservative care. So you can follow a fiber-rich diet, stay hydrated, take sitz baths, use topical creams, and practice careful hygiene as a safe approach while monitoring for any concerning changes.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.