Haemorrhoids and anal fissures

Anal fissures and haemorrhoids are two of the most common causes of anal bleeding, affecting people of all ages.

Pregnant women or women who have just given birth are particularly at risk of developing these painful bowel problems, due to increased pressure on the pelvis from the growing uterus. Pregnancy hormones can also slow down the flow of blood to the intestines, making passing a bowel motion more difficult. This can cause constipation and increase the risk of anal fissures and haemorrhoids. These bowel conditions can also develop after childbirth, due to intense pushing during the second stage of labour.

What is an anal fissure?

An anal fissure is a tear in the lining of the anus. Chronic constipation and childbirth are two of the main causes of fissures, but they can also be caused by other underlying medical conditions. Many anal fissures heal on their own, however, some fissures will require medical attention if the pressure of passing a bowel motion prevents the fissure from healing.

What are the symptoms of an anal fissure?

Symptoms of an anal fissure include:

  • Presence of blood after passing a bowel motion
  • Pain when passing a bowel motion, and sometimes afterwards
  • General pain around the anus

How is an anal fissure treated?

There are a number of things you can do at home to encourage healing of an anal fissure, some these things include:

  • Apply petroleum jelly – this will help to lubricate the anal area and make passing a bowel motion slightly easier.
  • Practice strict hygiene – always clean the area well after a bowel motion, and take regular shallow baths in warm salt water, otherwise known as a sitz bath
  • Speak to your pharmacist about creams that may help the healing process

If you need medical attention for a fissure, this may include:

  • Taking  prescribed laxatives to avoid constipation
  • Injections to relax the sphincter muscles (the muscles that control the opening of the anus)
  • Surgery

What is a haemorrhoid?

A haemorrhoid is a swollen or inflamed vein found in the rectum or anus. Like anal fissures two of the main causes of haemorrhoids are extreme constipation and pregnancy or childbirth. There are three different types of haemorrhoids:

  • Internal haemorrhoids – those found inside the rectum
  • Prolapsed haemorrhoids – those that have pushed through the anus and hang outside of the body
  • External haemorrhoids – those that appear as hard lumps on the skin around the outside of the anus.

What are the symptoms of a haemorrhoid?

The main symptom of a haemorrhoid is bleeding from the rectum or anus. Sometimes the bleeding is accompanied by pain, particularly in the case of a prolapsed haemorrhoid. Other symptoms of haemorrhoids may include:

  • Itching around the anus
  • Irritated skin around the outside of the anus
  • The feeling of needing to pass a stool, after already passing one

How is a haemorrhoid treated?

At home, the pain and itching associated with haemorrhoids can be relieved by:

  • Taking a sitz bath
  • Applying ice for 10 minutes at a time, followed by a warm compress for 10 minutes
  • Taking over-the-counter pain medicine
  • Not standing for long periods of time, and lying down as often as possible especially if you are pregnant.

Medical treatment for a haemorrhoid may include:

  • Prescription suppositories or ointments that shrink the haemorrhoid
  • Injections that shrink the haemorrhoid
  • Laser therapy or other light therapy
  • Surgery

Can you prevent anal fissures and haemorrhoids?

You can help to prevent bowel conditions like anal fissures and haemorrhoids by making sure that you avoid constipation. This can be done by:

  • Consuming fresh fruit and vegetables every day
  • Drinking plenty of water throughout the day
  • Exercising at least 3 times a week for at least 30 minutes at a time
  • Passing a bowel motion every day – take a fibre supplement if necessary. It is also important not to strain when having a bowel motion.


Rectal bleeding can also be caused by more serious conditions, including bowel cancer.  So, it is important to consult your doctor at the first sign of blood in your faeces or on the toilet paper after you have had a bowel motion.


This article was written by Jo Harris for Kidspot NZ, New Zealand’s best family health resource.


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