Q: Good morning Dr Ketch. Please, I have an anal fissure that has refused to go. I’ve changed my diet by taking foods high in fibre. Please, what do I do?

A: Constipation occurs when faeces passes too slowly down the digestive tract causing the stool to become hard and brittle. It leads to a situation where a person has less than 3 bowel movements per week. The classic symptoms are straining to pass stool, having the feeling of incomplete emptying after a poo and sometimes having to press down on your abdomen to help emptying. Sometimes, constipated people also insert a finger into their rectum to help the process along. Constipation becomes chronic when it persists for weeks on end.

Constipation may be due to blockages in the rectum, diseases like Diabetes Mellitus etc. However, they could be due to lifestyle issues like not drinking enough water, not eating enough fibre in our diets and being sedentary. Being a woman and getting older also pre-disposes one to more episodes of constipation.

It is possible that the stool is so hard that it has caused a tear of the skin lining the anus (anal fissure, as in your case) leading to the blood seen with the stool.

Prevention is focused on ensuring that you have enough fibre in your diet (fruits, vegetables, whole grain), getting at least 30 minutes of exercise daily and drinking at least 8 glasses of water daily. When you have the urge to poo, try not to delay it for too long. Go and try to take your time to do your business!

How can you help this?

• Include some fibre in your diet. Fruits and vegetables, oatmeal, local rice and other whole grain meals are helpful.
• Drinking at least 8 glasses of water daily. Remember that this number, 8, is not cast in stone. It’s just a helpful guide. If you’re in a hot area, you’ll probably drink more
• Get at least 30 minutes of exercise/activity per day or on at least 5 days of the week.
• If these do not help, you may want to see your doctor for a proper examination as some diseases like Diabetes Mellitus may also cause constipation.

I hope this helps 😀

Have a good night y’all 😀