Anal Fissures and Hemorrhoids

What are anal fissures?

Anal fissures are small tears or sores in the lining of the anus. They can cause a sharp pain and bleeding when you pass stool. Anal fissures are relatively common in Crohn’s disease and rare in ulcerative colitis. Sometimes anal fissures are present before signs and symptoms of IBD arise. 

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Management of anal fissures in IBD

To treat sore skin, use the measures described in our Anal Irritation and Itching section.

Most anal fissures go away with time but they can return if your constipation persists. If needed, they can be treated with high-fibre diets, or nitroglycerine or diltiazem ointment. If particularly severe, Botox injections can be used. 

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What are hemorrhoids?

Hemorrhoids are swellings around the anus that contain enlarged blood vessels. They can cause itching, soreness, or swelling around the anus, and pain and bleeding when passing stool. 

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Management of hemorrhoids in IBD

Hemorrhoids can be treated with over-the-counter creams or suppositories.

Hemorrhoids associated with constipation are best prevented by drinking lots of fluids, exercising regularly, eating fibre, not holding in your stool, and not straining while on the toilet. Always remember, if you are considering increasing your fibre intake, to talk to your dietitian first.

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