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Anal fissure and constipation caused flat deformed stool

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My fiance is suffering from an anal fissure and constipation that comes and goes. This morning sh gave herself an enema that produced an incredibly irregular shaped stool, very flat and compacted. I have a picture?

Category: Family Physician-GP

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Category: Family Physician-GP
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Welcome to Doctor Spring Forum.

Let me know the associated details along with mentioned.
Is she suffering from constipation since long time?
Does she has abdominal discomfort/ abdominal heaviness/ excessive flatulence?

With the available details and uploaded pictures, it can be concluded that deformed stool
shape is due to persistent constipation with anal fissure.
Pain while passing stool due to existent anal fissure may cause spasm of anal sphincter with
deformed stools.

Picture also showed dark colored stool which also signify persistent constipation.Persistent constipation could be due to decreased gastrointestinal motility, decreased fibre
intake, decreased water intake.

She should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up.She should also go for complete blood count, thyroid profile, blood sugar, serum calcium and xray abdomen.

She should take plenty of water, increased physical activity (daily walk > 5 KM per day enhances gastrointestinal motility), high fibre diet.
She should apply Diltiazem ointment at anus under guidance of treating doctor.She should also take hot sitz bath (helps in relaxation of anal sphincter), and laxative (helps in easy passage of stools and recovery).

Take care,
Let me know your other queries.
Get well soon,
Dr. Mayank Bhargava

Patient replied :

Thank you Doctor.
She has been constipated on and off for seven months, it started after a colonoscopy.
Yes with abdominal pain and heaviness and a feeling her buttocks are being pulled apart. No excessive flatulence.
Severe pain comes on rapidly, yesterday she had a pain free period of two hours then her stomach started hurting and immediately went to her buttocks, rectum/anus. her buttocks cannot be touched when the pain is at it's worse.
She takes two sitz baths per day but has stopped this weekend because it is so hard to sit. Applys the ointment twice per day. Physical activity is next to zero the past few weeks because of pain.
Thank you so much for your answer, we are going to emergency today to have this looked at again.
Best regards,

She should perform increased physical activity, increased water intake and high fibre intake as I have already advised.
She should also start hot sitz bath, and apply Diltiazem ointment.

Get well soon,
Dr. Mayank Bhargava

Dr. Mayank Bhargava
Category: Family Physician-GP
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
Dr. Mayank Bhargava and 4 other Medical Specialists are ready to help you

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