Am I still dealing with a fissure?
Age: 31 Sex: Male About a month back, I received a diagnosis of an anal fissure, yet I've noticed persistent bleeding during bowel movements. I've been applying a prescribed cream containing hydrocortisone acetate (2.5%) and pramoxine hydrochloride (1%). Recently, after some straining, I observed notable changes in the appearance of my anal area, with what seems to be some swelling internally. Is it possible that I'm still experiencing a fissure, could it be hemorrhoids, or is it something more serious? I would greatly appreciate any advice or insights.
Answers (1)

7/9/2025, 12:02:08 AM
OpenHealth AI
It sounds like you are continuing to experience discomfort and complications related to your initial diagnosis of an anal fissure. The bleeding, swelling, and changes in the appearance of your anal area can suggest that you may still have a fissure or that there could be another issue, such as hemorrhoids, particularly if you’ve been straining during bowel movements.
Explanation:
An anal fissure is a small tear in the lining of the anus, often causing pain and bleeding, especially during bowel movements. If you're still experiencing bleeding and swelling, it’s possible that your fissure has not fully healed or that you may have developed hemorrhoids as a result of the associated straining. Hemorrhoids can also cause similar symptoms, including swelling and bleeding.
Next Steps:
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Monitor Symptoms: Keep track of any changes, including the frequency and amount of bleeding, pain levels, and any new symptoms like itching or additional swelling. This can help you identify patterns and triggers.
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Dietary Adjustments: Focus on a high-fiber diet to help ease bowel movements and minimize straining. Food sources include fruits, vegetables, whole grains, and legumes. Staying hydrated is also crucial, as it helps soften stool.
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Gentle Hygiene Practices: After bowel movements, gently clean the anal area with unscented wipes or water. Avoid harsh soaps or scrubbing.
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Continue Using the Cream: Since you are currently using a prescribed cream with hydrocortisone and pramoxine, continue applying it as directed. These ingredients can help reduce inflammation and discomfort.
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Warm Sitz Baths: Consider taking sitz baths (sitting in warm water for 10-15 minutes) several times a day, especially after bowel movements. This can help relax the anal muscles and relieve pain.
If you notice persistent symptoms, significant changes, or worsening of the condition, it would be prudent to seek further evaluation from a healthcare professional. This may involve a more in-depth examination to rule out any serious issues and discuss additional treatment options.
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