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How to poop with anal fissure ?
How to poop with anal fissure?even after taking laxative (lactulose)and ointment(dialtazem gel).the pain and inflammation has reduced but it pains when stool touches the fissure ,my muscles become tight and stool goes back and smears the fissure which causes slight bleed.it has been 5days since I passed stool although I am taking light and soft diet since 5-6days(oats(meal1),khichdi (meal2)and papaya (meal3)sometimes rice).i think the stool needs more softness or maybe it has to be liquidy?I drink 11glasses water.
Answers (10)
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Take psyllium husk(isabhgol) twice a day with warm water and also do a sitz bath
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Tab zerodol sp three times a day after food for five days.
Oz tab two times a day after food for five days.
Application of ointment by index finger first on buthole than gently push inside the anus rotate the finger to cover anal mucosa completely before n after defication two times. Pain reduced after medicine.
Continue antibiotics constipating agent.
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Please consult a gen surgeon and get fissure removed surgically.
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In anal fissure, stool should be soft and smooth, not liquid. Very loose stool can also irritate the fissure.
Your main issue is muscle spasm (tightening), which is common in fissure and causes pain + stool going back.
What you can do:
• Continue lactulose, dose may need adjustment to get soft daily stool
• Warm sitz bath 2–3 times daily (very important)
• Apply diltiazem regularly as advised
• Do not hold stool when urge comes
• Avoid straining
If no stool for 5 days, doctor may add a stronger stool softener or short course laxative.
If bleeding and spasm continue, you may need further evaluation.
Based on your symptoms, this may require proper clinical assessment and prescription. You may book an online consultation with me for detailed evaluation and personalised treatment plan.
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Yes, you are on track.your diet is good also you need to take stool softener. So no worry its take time to heal.your main problem is constipation, because constipation make stool hard.so you need to add also isabgol before sleep.its help a lot.avoid tea coffee .please consult me on practo for further management and evaluation.
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What you’re describing is very typical of an acute anal fissure:
• Stool touches fissure → sharp pain
• Anal sphincter tightens (spasm)
• Stool goes back in
• Smearing + slight bleeding
• Fear of passing stool
• 5 days constipation
The main issue right now is anal sphincter spasm, not just stool hardness.
Even if stool is soft, the muscle spasm causes pain and incomplete evacuation.
Important:
Next Steps
1️⃣ Improve stool softness properly
Lactulose dose may need adjustment.
You can:
✔ Increase lactulose slightly (as per doctor guidance)
✔ Add Isabgol (1–2 tsp in warm water at night)
✔ Add 1 tsp ghee in warm milk at night
Goal = soft, bulky, smooth stool — not liquid.
⸻
2️⃣ Relax the muscle before passing stool
Very important:
✔ Take warm sitz bath (10–15 mins) BEFORE trying to pass stool
✔ Apply Diltiazem gel 20–30 mins before passing stool
✔ Do not strain
✔ Go when natural urge comes — don’t force
You can also:
✔ Use a footstool while sitting (squatting posture helps)
⸻
3️⃣ If no stool for 5 days
You may need:
✔ Glycerin suppository once
OR
✔ Microlax enema (under guidance)
Do NOT keep waiting longer — hard stool sitting inside makes fissure worse.
Health Tips
✔ Do not aim for watery stool
✔ Avoid holding stool due to fear
✔ Avoid spicy food
✔ Continue 2–3 L water daily
✔ Healing usually takes 2–3 weeks
If pain persists beyond 2–3 weeks, fissure may become chronic and need stronger medication.
You are very close to improvement — the key is breaking the pain–spasm–constipation cycle.
If you want, tell me your exact lactulose dose and your weight — I can help you adjust it properly. If this continues beyond a few more days, booking an online consultation will help prevent this from turning into a chronic fissure and avoid future complications.
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Kindly do connect and consult
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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