You’re mostly suffering from an anal fissure which is a small tear in the mucosa of the anal canal, commonly causing pain and bleeding during defecation along with Blood during defecation.
The evaluation involves history, examination, and in selected cases, further investigations to rule out secondary causes of your condition so visit a Surgery OPD and get yourself examined to check for the extent of the disease you’re suffering from and the grade of your ailment and whether the diagnosis we are suspecting is right
1. Tell me about your History properly
Key Symptoms that you can relate in cases of fissure are
• Sharp, burning pain during and after defecation
• Bright red blood on toilet paper or surface of stool
• Avoidance of defecation due to pain
• Constipation or hard stools
• Chronic cases: itching, discharge, skin tag (sentinel pile)
Also tell us more about the
• Duration: Acute (6 weeks)
• Bowel habits: constipation, diarrhea
• History of trauma or long sitting hours
• Any anal surgery that you got done recently
So my Next advice would be consult a Good General surgeon in the OPD
Till the time you can get these symptoms under control by taking
High-fiber diet- it will Soften stools
Plenty of water (2–3L/day)- Prevent constipation
Avoid straining during passing stools in morning - Reduces trauma
Sitz baths (you have to sit in warm water for 10–15 min, 2–3 times/day With buttocks submerged under water ) - it’s the most effective way to decrease the fissures as it relaxes your anal sphincter and preventing further damage and bleed
If you want I can consult and tell you about the proper technique and what to use for the media for Sitz Bath for proper treatment
You can also apply local creams like
A) 2% Diltiazem or 0.3% Nifedipine gel - which will work as a Smooth muscle relaxant and thus reduces sphincter spasm
(Use for atleast 6–8 weeks regularly)
B) 0.2–0.4% Nitroglycerin ointment - Increases blood flow, heals fissure which is very effective but may cause headache and avoid if hypertensive
C) Lidocaine 5% ointment - it’s a Local anaesthetic agent and get decrease the pain caused due to fissure
D)
Calcium Dobesilate 500mg once a day after meals - which is a vasoprotective drug with anti-inflammatory, anti-edematous, and antioxidant properties. It improves microcirculation and capillary permeability thus can be used here bút take regularly for 2-4 weeks if tolerated - avoid if you develop diarrhoea headache or stomach upset after taking this
E) High Fiber Diet
F) Syrup Duphalac 15ml at night to soften stools