Anal Fissure: Care Instructions

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Your Care Instructions

An anal fissure is a tear in the lining of the lower rectum (anus). It can itch and cause pain. You may notice bright red blood on toilet paper after you wipe. A fissure may form if you are constipated and try to pass a large, hard stool or if you do not relax your anal muscles during a bowel movement.

Most anal fissures heal with home treatment after a few days or weeks. If you have an anal fissure that takes more time to heal, your doctor may prescribe medicine. In rare cases, surgery may be needed.

Anal fissures do not lead to colon cancer or other serious illnesses. However, if you have blood mixed in with the stool, talk to your doctor.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • If your doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor or nurse call line if you think you are having a problem with your medicine. You will get more details on the specific medicines your doctor prescribes.
  • Sit in 8 to 10 centimetres of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases discomfort. Do not put soaps, salts, or shampoos in the water.
  • Avoid constipation:
    • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre.
    • Drink plenty of fluids, enough so that your urine is light yellow or clear like water. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
    • Get some exercise every day. Build up slowly to 30 to 60 minutes a day on 5 or more days of the week.
    • Take a fibre supplement, such as Benefibre or Metamucil, every day if needed. Read and follow all instructions on the label.
    • Use the toilet when you feel the urge. Or when you can, schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement. Do not sit on the toilet too long.
  • Support your feet with a small step stool when you sit on the toilet. This helps flex your hips and places your pelvis in a squatting position.
  • Your doctor may recommend an over-the-counter laxative, such as Milk of Magnesia or Ex-Lax. Read and follow all instructions on the label, and do not use these medicines on a long-term basis.
  • Do not use over-the-counter ointments or creams without talking to your doctor. Some of these preparations may not help.
  • Use baby wipes or medicated pads, such as Preparation H or Tucks, instead of toilet paper to clean after a bowel movement. These products do not irritate the anus.
  • Be safe with medicines. Read and follow all instructions on the label. If the doctor gave you a prescription medicine for pain, take it as prescribed. If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

When should you call for help?

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You do not get better as expected.
  • You have difficulty passing stools.
  • You have any new symptoms, such as blood in your stools.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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