Managing Haemorrhoids with an Anal Fissure
I’m a 46-year-old female, 5’7” tall, weighing 8 stone 13 pounds. I’m currently taking 1-2 sachets of Laxido each day and using 10mg of propranolol as necessary due to my anxiety, which is compounded by a history of breast cancer and spontaneous pneumothoraces. I hope to find some guidance since my colorectal surgeon is currently unavailable until next week, and the nursing staff are unsure about the best course of action during this time. Around four weeks ago, I received Botox treatment for a persistent anal fissure. During the examination under anesthesia (EUA), my colorectal surgeon identified some haemorrhoids, but deemed them too small for banding at that time. Unfortunately, these haemorrhoids have worsened since then; at times, one protrudes during a bowel movement. While it does retract on its own, I often feel a sensation of fullness, which heightens my anxiety. I do not strain during bowel movements, and my stools are usually soft (classified as types 4-5 on the Bristol stool chart), but I suspect that I sometimes experience incomplete evacuation due to potential pelvic floor dysfunction. I have been seeing a pelvic floor physiotherapist but struggle to consistently maintain my home exercise routine. My main concern is whether it is acceptable to utilize creams or suppositories to help diminish the size of the haemorrhoids while I still have the anal fissure. Or am I simply left to endure the discomfort of the haemorrhoids until the fissure has healed, assuming it ever does? I have been dealing with this issue for several months, possibly even up to two years, and it’s severely affecting my mental well-being, sleep, and overall sense of self. I appreciate your help in advance. 🙏🏻
Answers (1)

9/6/2025, 12:30:58 PM
OpenHealth AI
It sounds like you're dealing with a challenging situation involving both hemorrhoids and an anal fissure, which can understandably cause discomfort and anxiety. It's important to address both concerns while ensuring your well-being throughout your recovery process.
Key Points:
- Managing Hemorrhoids and Fissures Together: You can use certain topical treatments for hemorrhoids even while dealing with a fissure.
- Self-Care Strategies: Focus on hydration, diet, and gentle bowel care to help manage both conditions.
- Considerations for Your Mental Well-Being: Acknowledge your emotional health during this time and incorporate practices to reduce anxiety.
Explanation:
Hemorrhoids and anal fissures can indeed be interrelated issues, as both arise from similar causes related to bowel habits and pressure in the anal area. Hemorrhoids can become more pronounced when you're experiencing discomfort from a fissure, and this can exacerbate your feelings of fullness or pressure.
Using topical treatments—like creams or suppositories that contain hydrocortisone or witch hazel—can help reduce the swelling and discomfort of hemorrhoids. It's important, however, to avoid irritants and ensure any products used do not worsen the fissure. If you have had a recent Botox treatment, keep in mind that your fissure may need additional time to heal.
Next Steps:
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Topical Treatments: Consider using over-the-counter creams or suppositories specifically for hemorrhoids. Look for products that are soothing, but avoid any that might exacerbate the fissure.
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Diet and Hydration: Maintain a high-fiber diet (fruits, vegetables, whole grains) and continue taking Laxido to help keep your stools soft and prevent straining. Aim for at least 2 liters of water a day to stay well-hydrated.
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Bowel Habits: When you feel the urge to go, try to do so promptly and avoid straining. Taking your time and relaxing during bowel movements can also help with the pressure.
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Pelvic Floor Exercises: Even if maintaining a consistent routine is challenging, try incorporating even short, gentle exercises into your day. These exercises can significantly aid both the fissure healing and bowel function.
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Mindfulness and Anxiety Management: Since this situation is affecting your mental well-being, consider practices such as mindfulness, deep-breathing exercises, or gentle yoga to help reduce anxiety levels during this time.
Please do keep track of any significant changes to your symptoms, including increased bleeding or pain, and reach out to your healthcare provider when available for tailored medical advice. Take care of yourself, and remember it's essential to prioritize your comfort and mental health throughout this process.
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