Coronavirus Update: MORE INFORMATION

Anal Disorders

Some topics are easier to discuss with your doctors than others, but it is important that you are keeping us informed about any concerns you might have. Here at Physician's East, our team of professionals provide a high level of discretion and respect for your privacy. 

Anal Bleeding

Anal bleeding is typically noticed by patients after a bowel movement. It may or may not be accompanied with pain, but can be seen on the stool, toilet tissue or in the toilet basin. There are several causes of minor anal bleeding, including colon cancer. Therefore, an experienced healthcare provider should evaluate any bleeding from the anus or rectum as soon as possible. Other causes of minor bleeding include hemorrhoids, anal fissures and proctitis (inflammation of the rectum).

If you are experiencing large amounts of blood from the rectum, stools that appear black, maroon in color, have a tar-like consistency or any other symptoms that concern you, you should call your Physicians East healthcare provider immediately or go to the nearest emergency room. We can be reached at 252-413-6260.


To diagnose the cause of anal bleeding, your healthcare provider will usually begin with a physical exam to look for any visual evidence of anal fissures, hemorrhoids or any other abnormalities. They may also perform an internal examination to feel for abnormalities, such as tumors. If the provider deems it necessary, anal bleeding may also be evaluated using colonoscopy or flexible sigmoidoscopy. Both procedures allow a physician to visualize the colon.

Treatment Options

Treatment for anal bleeding depends on the underlying cause and ranges from fiber supplements and stool softeners for anal fissures to surgery for colon cancer. If you have any anal bleeding, please call us at 252-413-6260 so we can discuss your options.

Anal Fissures

An anal fissure is a small tear in the thin tissue that lines the lower rectum. Anal fissures can occur at any age, even in infancy. In adults fissures are often caused by passing large firm stools (i.e., constipation) or having diarrhea for an extended period of time. Anal fissures are also often seen in women after childbirth and in people with Crohn’s disease. People who suffer from anal fissures typically experience painful bowel movements and minor anal bleeding.

Man standing in kitchen and cutting vegetablesDiagnosis

Anal fissures can be diagnosed by one of our providers after a thorough physical examination has been performed. 

Treatment Options

In many cases, anal fissures do not require treatment and heal on their own. If constipation is contributing to the development of anal fissures, try eating more fiber (e.g., fruits, vegetables), drink more water and use stool softeners. Some people may need prescription creams or, if deemed necessary, minor surgery to relax the anal muscle so that stool passes more easily and pain free. 


Hemorrhoids refer to swollen veins within the anal canal. When hemorrhoids develop, symptoms like pain and bleeding may become bothersome. Hemorrhoids are common and many people do not have initial symptoms.

There are two types of hemorrhoids: internal and external. Internal hemorrhoids form inside the rectum and above the opening of the anus. In some instances, these can swell to such an extreme that they protrude out of the anus. External hemorrhoids are covered by skin and may feel like a bump near the outside of the anus. These become painful when swollen with blood. Hemorrhoids occur due to repeated straining with bowel movements, often times from long-term constipation, post child-birth and other conditions that put intense pressure on the anus. 


External and protruding internal hemorrhoids may be seen on visual inspection. Alternatively, a healthcare provider can detect hemorrhoids during an exam, where he or she carefully and gently inserts a gloved finger into the rectum. Sometimes a tube with a light (i.e., anoscope) or camera (i.e. sigmoidoscope) may need to be inserted to fully evaluate the problem.

Treatment Options

Usually hemorrhoids resolve on their own or with simple solutions, such as changing the person’s diet to include more fiber or with the use of topical creams. If warranted, some hemorrhoids require procedures such as rubber band ligation or surgery for removal.