What lifestyle and dietary modifications should I advise to prevent recurrence of anal fissures?

Lifestyle and dietary modifications to prevent recurrence of anal fissures include:

• Advise a gradual increase in dietary fibre intake by eating a balanced diet containing whole grains, fruits, and vegetables to ensure stools remain soft and easy to pass, which helps prevent constipation and straining during defecation.
• Encourage adequate fluid intake alongside increased fibre to maintain soft, well-lubricated stools and prevent intestinal obstruction.
• Advise against straining and mechanical irritation during bowel movements, as these can worsen or cause fissures.
• Promote good anal hygiene by keeping the perianal area clean and dry, washing gently with plain water after bowel movements, and avoiding excessive rubbing or use of irritants such as alcohol-based wipes.
• Recommend avoiding stool withholding, which can lead to constipation and fissure formation.
• Suggest sitting in a shallow, warm bath several times a day, especially after bowel movements, to relieve pain and reduce sphincter spasm.
• Advise wearing loose cotton underwear and avoiding tight clothing to reduce sweating and moisture around the anal area.

These measures collectively aid healing and reduce the risk of fissure recurrence.

Note: If symptoms persist beyond one week without improvement, consider medical treatments such as topical glyceryl trinitrate ointment in addition to lifestyle measures.

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