Anal fissure due to prolapsed hemorrhoids?

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Hello doctor. I have had hemorrhoids for many years, more than 15 years. From the past until now, hemorrhoids always come out when I go to the toilet, I push in with my hand but it doesn't hurt. I recently had an anal fissure and it was very painful when I went to the toilet and when I pushed in. Doctor let me ask if that anal fissure is caused by hemorrhoids? Should I treat hemorrhoids with ligation or surgery? How long does it take to return to normal life? I hope you can give me some advice, thanks.
Tuyet (1988)
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Hello, according to the description, you have internal hemorrhoids grade IV (must be pushed in by hand) or combined external hemorrhoids. Anal fissures are often caused by constipation, prolonged hemorrhoids are also a factor that causes inflammation in the anal area, making it more susceptible to anal fissures. Her case needs to be examined specifically to have a treatment direction, a large possibility is surgical intervention. The time to return to work after surgery is usually about 1 week.
Thank you for your question to Vinmec Health System. Best regards!
Master, Doctor Nguyen Ngoc Thang - Gastroenterologist - General Surgery Department - Vinmec International General Hospital Da Nang.
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