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Suggest Treatment For Anal Fissure

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Posted on Mon, 27 Oct 2014
Question: I am having pain in the anus when passing bowels. It is a searing, pinching pain which is so unbearable that I am afraid to go for bowels when I have to. My family doctor had diagnosed it as Anal Fissure and prescribed high fiber rich diet, Shield cream, and Duphalac syrup and Sitz Bath with betadine and warm water. But from the past couple of days, I am noticing a small lump in my anus passage but it does not pain when pressed and there is no bleeding. But the pain is unbearable and excrutiating. Please help me....Thank you.
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Answered by Dr. M Y Shareef (31 minutes later)
Brief Answer:
Possibly the lump noticed by you is a skin tag

Detailed Answer:
Hi ! Good morning. I am Dr Shareef, a general surgeon answering your query.

From your history, it seems that you have developed a fissure in ano ( a cut in the perianal skin) due to passage of hard stool due to which there is pain over there and bleeding due to the ulcer.

The lump noticed by you at the perianal area is possibly a sentinel tag - a tag of skin over the fissure for natural protection of the fissure.

If I were your doctor, I would first examine the area clinically, and after confirming that it was a fissure, would go for some anti inflammatory drug along with a proton pump inhibitor, a broad spectrum antibiotic, and a stool softener like lactulose liquid at bed time. Add sitz bath to it (sitting on a XXXXXXX warm water filled tub) three to four time a day for five minutes each. I am hopeful that you would get relief with this strategy, but I am afraid it would return if constipation (hard stool) occurs again for you. Therefore, to prevent the constipation, please avoid high protein diet, add a lot of roughage and fresh fruits along with sufficient liquids. Go for a regular exercise programme. You could continue with the Shield ointment and Duphalac syrup as advised by your doctor. If nothing helps and it has become a chronic problem,

I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.

Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef
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Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. M Y Shareef

General Surgeon

Practicing since :1979

Answered : 2457 Questions

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Suggest Treatment For Anal Fissure

Brief Answer: Possibly the lump noticed by you is a skin tag Detailed Answer: Hi ! Good morning. I am Dr Shareef, a general surgeon answering your query. From your history, it seems that you have developed a fissure in ano ( a cut in the perianal skin) due to passage of hard stool due to which there is pain over there and bleeding due to the ulcer. The lump noticed by you at the perianal area is possibly a sentinel tag - a tag of skin over the fissure for natural protection of the fissure. If I were your doctor, I would first examine the area clinically, and after confirming that it was a fissure, would go for some anti inflammatory drug along with a proton pump inhibitor, a broad spectrum antibiotic, and a stool softener like lactulose liquid at bed time. Add sitz bath to it (sitting on a XXXXXXX warm water filled tub) three to four time a day for five minutes each. I am hopeful that you would get relief with this strategy, but I am afraid it would return if constipation (hard stool) occurs again for you. Therefore, to prevent the constipation, please avoid high protein diet, add a lot of roughage and fresh fruits along with sufficient liquids. Go for a regular exercise programme. You could continue with the Shield ointment and Duphalac syrup as advised by your doctor. If nothing helps and it has become a chronic problem, I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef