What to do in described situation

1. Your symptoms of repeated urge to pass stool, burning pain, and discomfort suggest a combination of anal fissure irritation and bowel sensitivity (IBS-like features).

2. Even if the stool looks normal, fissure pain and nerve sensitivity can create a false urge to poop multiple times.

3. Creams alone may not fully help if there is ongoing irritation treatment often needs a high fiber diet, plenty of fluids, stool softeners, and sitz baths.

4. Avoid straining, spicy food, caffeine, and irregular eating habits, as these worsen both fissure and IBS symptoms.

5. Since your daily life is getting affected, you should consult a gastroenterologist or colorectal surgeon sometimes minor procedures or advanced medicines give long term relief.

6. Please don’t ignore this with proper care, fissure pain and bowel cycle disturbance usually improve, and you can get back to normal activities.

Hi Sir,

The cycle you’re facing sounds like a mix of anal fissure pain + IBS hypersensitivity. Fissure pain + IBS urges reinforce each other. Pain makes you strain more, IBS makes you go more often.

For fissure; 1.SITZ BATH 2. Soft stool- keep hydrated 3.Cream Anovate(before and after stool )

For IBS;

Lifestyle changes + stress free + diet control Try a regular routine (pooping at same time daily, morning is best). Track triggers: dairy, spicy/oily food, excess caffeine, anxiety.

Consult a gastroenterologist in person if condition is not subsiding Stay hydrated, healthy. Keep calm ,you’ve got this!!

Hope this settles uour concern Thank you

You have mixed anal fissure + IBS-like features. Continue fissure cream + stool softening, add dietary fiber + probiotics + sitz bath. Medicines alone won’t help unless you also manage lifestyle + anxiety component.

Visit a surgeon.

Hi Dear Ghosh, It is called as Tenesmus where there is urge to defecate Kindly take adequate dietary fibre and adequate hydration sometimes anal fissure IBS or proctitis might be the cause of it Needs antiinflammatory and good dietary habits Kindly take care

sounds like you are experiencing persistent anal discomfort, urgency, and fear of using the toilet in public, along with incomplete relief even after treatment — this can be both physical (anal fissure, possible IBS) and psychological (anxiety around bowel movements, fear of embarrassment). Since your current treatment hasn’t helped, it’s important to consult both a gastroenterologist for a thorough evaluation (to rule out persistent fissures, hemorrhoids, or other bowel conditions) and a mental health professional (psychologist/psychiatrist) to address the anxiety and fear around defecation. Meanwhile, keeping a stool diary, practicing gentle anal care, and relaxation techniques may help reduce discomfort and anxiety until you get proper care.

Hello Mr. Ghosh,

I understand your concern and this must be worrisome, but I am here to help.

It looks like you have a combination of anal fissure + bowel irregularity (IBS like/funtional), and fissure may have occurred due to the bowel irregularity.

My advice to you -

Diet: Eat high-fibre food (fruits, salads, whole grains), drink 2–3 litres of water daily, avoid spicy/oily food, reduce tea/coffee.

Lifestyle: Regular sleep, stress management, daily walk/yoga can help regulate bowel habits.

Anal Fissure - Warm water sitz bath, twice daily (take lukewarm water in a tub, and add a pinch if salt) Oint Lignocaine 5% for local application before passing stool. Syp. Lactulose 15 ml, at night

IBS Symptoms - Tab. Lactic Acid Bacillus, 1 tab. twice a day × 7 days Tab. Drotaverine+Mefenamic Acid, take 1 tablet when you feel pain.

If your symptoms don’t improve, I advise you to get -

Colonoscopy/Sigmoidoscopy done to rule out other causes due to which this might be happening. Also, get done Stool test (routine & occult blood).

Feel free to reach out again.

Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Med

It sounds like you’re dealing with quite a complex set of symptoms that are affecting your daily routine. With a previous diagnosis of an anal fissure and potential IBS, it’s essential to approach this from a multifaceted perspective. First, let’s tackle your bowel movements. Considering the persistent feeling of incomplete evacuation and frequent urge to go, a few strategies may help. Try increasing your dietary fiber intake gradually, aiming for fruits, vegetables, whole grains, and potentially a fiber supplement like psyllium, which may help form softer, bulkier stools reducing irritation. It’s crucial to drink plenty of water throughout the day to aid this process and prevent further constipation or straining. However, since IBS was suggested, it might help to identify and avoid personal dietary triggers. Common triggers include spicy foods, caffeine, dairy, or certain artificial sweeteners. Keeping a food diary can help pinpoint the culprits. As for the burning sensation, the prescribed cream should be used as directed. If the cream hasn’t been helping, it might be worthwhile to discuss other options with your healthcare provider, such as topical anesthetics or soaking in warm sitz baths to soothe the area. Pelvic floor exercises might also alleviate rectal discomfort, as strengthening these muscles could reduce urgency and improve continence. Since your symptoms are persistent and affecting your mobility and comfort, it might be beneficial to get a second opinion. Re-examining the diagnosis or exploring further investigations like anorectal manometry or a colonoscopy might be necessary, particularly if symptoms worsen or don’t improve with these measures. In summary, while dietary and lifestyle adjustments are foundational, don’t hesitate to reach out your doctor for reassessment if your current plan isn’t bringing relief. It’s important to ensure there isn’t another underlying issue.