I have an anal fissure with burning sensation while passing stools. Please help.

Hello,

Welcome to icliniq.com.

Yes, it is an anal fissure (attachment removed to protect patient identity), a breach in the skin around the anal canal. It can occur spontaneously but usually follows after a forceful passage of stools or a passage of hard stools. Most fissures heal themselves but require conservative treatment. I suggest you follow the following regimen for now.

Take Ispagol husk two tablespoons full in a glass of water daily. For one week and whenever you have felt like constipation, such as hard stools.

Apply Xylocaine (lignocaine) 2% gel over the anal fissure area with the help of a finger. Do not rub against it. Just apply gently. Apply four to six-hourly, for a few days until your pain settles.

Apply Levorag Emugel cream (dimethicone and glycerine) for local application over the anal fissure area. This is a soothing cream that helps relieve your pain and burning. Apply four hourly for 5 to 7 days. If this cream not available, purchase Diltiazem gel (diltiazem) and apply it similarly to others.

Sitz bath, take a water tub. Fill it half with slightly warm water. Add 5 ml Dettol or Savlon (antiseptics). Sit in the tub for 15 minutes at least, a total of three times in a day.

Did you have bleeding as well? And do you have constipation before, and did this ever happened before in your lifetime? Your weight is 165 lbs, have you gained weight recently? And did you observe any worms in the stools?

Kindly let me know the above things, as I may suggest you some other precautions besides the above treatment regimen.

Hello,

Welcome back to icliniq.com.

No, at the moment no need to visit any clinic. There is nothing serious in it except the pain, and sometimes bleeding can cause. But again, this is manageable at home. Plus, you already had an opinion with me, so no more opinion is required.

To prevent it from happening, you should use fiber almost daily in your meals, including bran, brown bread, lots of fruits (not juices), and lots of vegetables. Increased intake of meat would make you constipated because it contains very little amount of fibers.

Or you can also use Ispagol husk (dietary fiber) two tablespoons full daily with water daily. This will enable you to have a soft and good amount of stools, which would not cause this anal fissure again.

You need to reduce some weight, say in the coming six months. Try to reduce at least 7 to 10% of your current body weight. You are right that it can heal spontaneously. However, the size of this anal fissure is a bit concerning to me. That is why I suggested lots of ointments for application to heal more rapidly and reduce the pain.