Q. I see bright red blood whenever I pass hard stools. Is anal fissure the cause?

Answered by
Dr. Sugreev Singh
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Sep 26, 2020 and last reviewed on: Sep 30, 2020

Hi doctor,

I see blood in the stool or sometimes on the surface of the stool or in toilet paper, which is on and off. I do not have pain any longer, but I guess you can say I have a mild burning after passing significant fecal matter. I was wondering if anal fissures could repeat themselves whenever you pass thick stools. Everything started two years back when I had iron deficiency and other vitamin deficiencies. Passing stool while using iron supplements was a complete nightmare like my bum was burning like hell. And eventually, I started to see bright red blood on the toilet. When I went to the doctor, he said I had fissures. If I am having diarrhea or loose stools, I do not see any blood, though.

Once I dropped iron supplements, the pain seemed to go away, but whenever I pass a thick and solid stool, I see bright red blood on toilet paper or the stool's surface, with a minimal amount, though. I still have an itchy pain, but it is not stronger as I had two years back. That pain was unbearable. After stopping taking the supplements, the blood thing was on and off. I was seeing it two to three months later.

Now I started retaking iron supplements (I lack Ferritin, but my other levels are standard). They are not making me constipated, unlike my first iron supplements, but today, I passed thick, quite long stools, and I saw a small amount of bright red blood in toilet paper and on the surface of my stool.

So my question is, can anal fissures repeat themselves like that whenever I pass a hard one? Can they persist over the years by repeating themselves? If I go to the doctor, can he or she still see my anal fissures even if the symptoms are on and off?



Welcome to

Thank you for writing to me, and I am concerned about you. Yes, if there is a fissure doctor can see it by colonoscopy or rectal examination. Most of the time, reasons for such fissures are iron deficiency or constipation. When a person has constipation, it leads to concrete stool formation, and when a person passes that stool, due to constant injuries or pressure, fissures develop. In such a condition, along with medicine, it is essential to take a healthy diet. If you eat more veggies and fruits and juices, they all will make your stool to pass quickly. And there will not be any pain or blood. You should avoid eating spicy food in such a condition. In a situation like constipation, you can take Syrup Lactulose 10 ml two to three times a day when you feel the hardness in passing stool. It will make you more comfortable. Suppose you want to know or ask anything else, please message me. Thank you.

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