Perineal tear from a bowel movement: what to know

Passing a hard or large stool can stretch tender tissue around the vaginal opening and anus. A recent birth tear, stitches, scar tissue, dryness, skin irritation or a small anal fissure can make pain or splitting more noticeable. Bright blood on toilet paper may come from a surface crack, but bleeding from the vagina, anus or an open perineal wound can be difficult to distinguish at home. The exact site should be checked if symptoms continue.

Avoid pushing hard. Drink fluids, eat fibre-rich foods and use a stool-softening medicine only if a clinician or pharmacist says it is suitable. Rinse with warm water, pat dry and avoid fragranced products. Pause activities that rub the area, including intercourse, until pain and any open skin have been assessed. Perineal Repair may help you understand wound treatment, and Postnatal Physiotherapy may support recovery after birth-related injury.

Arrange prompt medical review for repeated bleeding, increasing pain, a visible gap in the skin, pus, foul-smelling discharge, fever, worsening redness or trouble passing stool. Seek urgent care for heavy bleeding, dizziness, severe pain, inability to pass stool or urine, or loss of bowel control. Do not assume that a small-looking tear is harmless if it is not settling.

Ask whether the injury is vaginal, perineal or anal, whether constipation or a fissure is contributing, and how to keep stools soft. Ask which pain relief is appropriate, whether the wound needs repair, and when you can resume exercise or sex.