What to do about anal fissure after hemorrhoid surgery

In general, the treatment methods for anal fissures after hemorrhoid surgery mainly include basic care, local medication, oral medication, physical therapy, and surgical treatment. The details are as follows:

1. Basic Care Treatment

After surgery, the wound is fragile, so maintaining perianal cleanliness and ensuring smooth bowel movements are crucial. Gently sit in warm water after defecation to clean the wound and relax the sphincter muscles, preventing residual stool from irritating the fissure. Eat a light, easily digestible diet rich in fiber—such as bananas and celery—and drink plenty of water to soften stools. Avoid excessive straining during bowel movements.

2. Local Medication Treatment

Topical medications directly applied to the wound can relieve discomfort and promote healing. Patients may use nitroglycerin ointment as directed by a physician to relax the anal sphincter and improve local blood flow; recombinant human epidermal growth factor gel to accelerate wound repair; and compound alginated ester cream to protect the mucosa and reduce friction-related pain during defecation.

3. Oral Medication Treatment

Oral medications help manage symptoms such as constipation and pain. For constipation, lactulose oral solution or polyethylene glycol 4000 powder can be taken to soften stools and reduce tension on the fissure. For significant pain, ibuprofen sustained-release capsules may be taken under medical supervision to alleviate discomfort and create favorable conditions for wound healing.

4. Physical Therapy

Physical methods can assist in symptom relief. In addition to warm water sitz baths, infrared irradiation therapy may be used. The thermal effect improves blood circulation in the anal region, reduces inflammatory responses, accelerates fissure healing, and relieves postoperative pain caused by muscle spasms.

5. Surgical Treatment

Surgery may be required if conservative treatments fail or the fissure does not heal over time. Common procedures include excision of the anal fissure to remove diseased tissue. If sphincter spasm is present, internal anal sphincterotomy may be performed to reduce local tension and promote healing. Surgery should avoid areas where wounds from prior hemorrhoid surgery have not fully healed.

In addition, patients must strictly follow medical advice for dressing changes and attend regular follow-up appointments to monitor wound recovery. If abnormal symptoms such as increased bleeding, worsening pain, or fever occur, immediate medical attention is necessary to adjust the treatment plan promptly.