What causes anal fissures and bleeding when pooping?

Bleeding caused by anal fissure is a common occurrence in life. What is needed is that patients should undergo timely examination and treatment and pay attention to their own hygiene. The symptoms of anal fissure are generally severe pain and bleeding, and the pain is usually felt during bowel movements.

1. The clinical symptoms of anal fissure are pain and bleeding. The pain is very characteristic, with a sudden knife-like pain during defecation (caused by feces cutting the skin of the anal canal), followed by a brief relief, and then long-term anal pain (caused by spasm of the anal sphincter after stimulation). It is common in clinical practice that patients are afraid of defecation due to fear of pain, resulting in a vicious cycle of "fear of pain - holding back defecation - dry stool - more pain". The bleeding caused by anal fissures can be more or less depending on the degree of blood vessel tearing. It is common to see anemia due to long-term or heavy bleeding from anal fissures.

2. If anal fissure is not treated in time in the early stage , three symptoms will appear: anal canal ulcer (fissure fibrosis, also known as old anal fissure), hypertrophy of anal papillae (polypoid tumors), and sentinel hemorrhoids (skin tag hyperplasia). If the disease continues to develop, anal sinusitis (chronic inflammation of the anus) and anal fistula (suppurative inflammation of the anus) may also appear, which are collectively called the "five characteristics of anal fissure" together with the first three symptoms. There is also the possibility of anal canal cancer due to long-term chronic inflammatory stimulation.

3. Typical symptoms are pain, constipation, and bleeding. During defecation, dry and hard feces directly squeeze the ulcer surface and stretch the fissure, causing severe pain. The pain is temporarily relieved after the feces are discharged. After a few minutes, due to the reflex spasm of the sphincter, it causes a longer period of intense pain, and some painkillers are needed to relieve the pain. Therefore, patients with anal fissures are afraid of defecation, which makes constipation worse, forming a vicious cycle. There may be a small amount of bleeding when the wound surface is broken, and blood may drip on the surface of the stool or after defecation.

4. During the examination, use the thumbs of both hands to gently separate the anus to see the ulcer surface. The edges of the new anal fissure are neat and soft, the ulcer bottom is shallow, there is no scar tissue, and it is red and easy to bleed. Chronic anal fissures are deep, hard, grayish white, and not easy to bleed. Below the fissure is the "sentinel pile". Anal digital and anoscopy examinations can cause severe pain to the patient and should not be performed.