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Need advice for my bleeding reasons
I had fistula -in-ano surgery two years back, since then, whenever I get hard stools my anus starts bleeding,I was thinking it will be healed with time but it's not,even 2 years passed...can you please guide me what could be the reason and suitable treatment.. Thankyou .
Answers (8)
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This looks like a anal fissure though a thorough examination is needed to evaluate further.
Next Steps
Need to take a high fibre diet, continue Sitz bath twice daily for 20mins, apply lignocaine gel 2% locally inside the anal canal, take stool sofners and adequate hydration is mandatory for atleast 3-4 months
Health Tips
consult a General Surgeon for confirmation and proper evaluation.
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To understand your condition I need to know what is your food habits and how much water intake you take daily ?
There has to be dietary modification and lifestyle modification which you should follow.
Also hard stools causing bleeding points to suspicioun of fissure (crack at the anal opening)
You need proper consultation for this
You can consult me if you need help with
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According to your case discription, you have chronic anal fissure.
This may predispose to chronic anaemia and further complications.
Next Steps
it's better to get it evaluated by a General surgeon or proctologist.
Health Tips
Continue high fibre diet with laxative for symptomatic relief.
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✓Case of chronic anal fissure ,Your problem is not delayed healing, it is recurrent injury due to hard stools.
✓Once stool softness + sphincter relaxation are corrected, bleeding usually stops permanently.
Next Steps
✓Diltiazem 2% gel
Apply inside anus, twice daily,6 week ..
✓sitz bath twice a day,for 15 min
✓
Isabgol 2 tsp nightly
Health Tips
consult with your nearest surgeon if symptoms persist
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Needs examination and further evaluation
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U need to visit proctologist for clinical examination bcuz bleeding may also occure for other reason like piles , fissure in ano etc . not bcuz of only surgery so kindly rule out other cause
Next Steps
Take green vegetables high fiber diet , avoid hot and spicy food, take sitz bath regularly
Health Tips
Visit nearest coloproctologist for examination properly
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Dr. Manu Maheendran
General Surgeon
13 yrs exp
Kottayam
Hello 🙏
Since bleeding occurs only with hard stools and even after 2 years of fistula surgery, this is most likely due to a chronic anal fissure or recurrent small tear, not delayed healing of the fistula surgery.
Hard stools repeatedly injure the area, causing fresh bleeding.
What helps:
Keep stools soft (high fibre diet + plenty of fluids)
Stool softener if needed
Diltiazem 2% gel locally for 6 weeks
Warm sitz bath twice daily
Most cases improve once stool consistency is corrected.
If bleeding continues despite proper treatment, a surgical review is advised to rule out fissure persistence or other causes.
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Dr. Ankush Bansal
General Surgeon
7 yrs exp
Faridabad
Bleeding with hard stools after fistula surgery is commonly due to an anal fissure, scar-related tightness, or associated hemorrhoids rather than fistula recurrence.
Treatment focuses on softening stools, high-fiber diet, adequate fluids, sitz baths, and local ointments.
A colorectal examination is advised .
Next Steps
Diet and lifestyle modification
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PR examination
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.