What is fissure-in-ano?
Anal fissures, also medically called as Fissure-in-ano, is nothing but a painful condition where there is a longitudinal cut on the skin of the anus. Due to friction or scratch or trauma, there may be a cut or fissure formation. Males, females including adults as and children may get affected with Fissure-in-ano.
The rear part of the anus is a common spot affected due to the poor blood supply, leading two formation of the fissure and difficult healing. Some conditions such as constipation, chronic diarrhea, ulcerative colitis, Crohn's disease, etc. could trigger or lead to fissure formation.
Common Symptoms of Fissure-in-ano
01 Pain while passing motions: Painfulness of the anus where there is a cut, is the most common symptom. The pain typically described by the patient is as cutting, shooting, agonizing, burning or even excruciating. It may last for a few hours after passing stool due to friction, fresh trauma, inflammation, and infection. It would start soon while passing stool, at times, preventing the defecate. Children may avoid passing stool due to anticipated pain. If the patient has consumed spicy food, there could be burning while passing stool; and afterward. The pain may subside after a few minutes or a few hours; to re-appear after the next call for passing stool.
02 Severe anal spasm (as a protective reflex)
03 Hard stool may cause friction on the wall of anus giving blood streaked stool. There may be frank bleeding after passing stool, which is likely to be bright red in color.
04 Itching, Discharge, swelling are common symptoms of chronic fissures.
Types of Fissure-in-ano
Fissure-in-ano may be acute (less than 6 weeks of duration) fissure or chronic (more than 6 weeks of duration) or recurring fissures.
Fissure-in-ano is largely considered as a medico-surgical disorder. However, looking at it in the light of homeopathic medicine, it is medically correctible conditions. It is possible to avoid surgery using homeopathy, in most cases.
Causes of Fissure-in-ano:
The most common cause of fissure-in-ano is constipation. Chronic constipation due to any reason (such as due to lifestyle, habitual, drug-induced, due to pregnancy, etc.) leads to recurring abrasion or forceful rubbing of the anal mucosa, which leads to a fissure. The current theory also suggests that sphincter spasm and accompanying ischemia; may precipitate the development of fissures and prevent them from healing in some people. The other less common causes can be
- Following a bout of diarrhea or following passage of bulky or hard stools (especially in children)
- Multiple pregnancies
- Chronic use of purgatives
- Rarely, a fissure may be the manifestation of underlying disease e.g. Crohn's disease, ulcerative colitis, sexually transmitted disease, or cancer.
- Wrongly performed an operation for piles
When choosing the homeopathic remedy for a fissure, the causative factors are always evaluated, and homeopathic medicine encompassing this cause is chosen. The remedy chosen in such a way not only heals the fissure but also does not allow the problem to recur.
Diagnosis of Fissure
The diagnosis of fissure-in-ano is easy to make clinically and usually, no complicated procedures are required to diagnose this condition. Examination by a proctoscope is better avoided. The physician will usually try to avoid putting any instrument in the anus, as the area is extremely sensitive and such examination can be very painful. In the majority of cases, with careful evaluation of the symptoms and a close look at the anus, a diagnosis of fissure can be confirmed by a trained doctor.
On examination, the doctor may observe the following:
- Spasm of the anus
- A split or cut in the posterior midline of the anal mucosa.
- Lateral fissures: If fissure is observed laterally, instead of posterior midline location of the fissure, it may give hint to underlying diseases such as Crohn’s disease, ulcerative colitis, or sexually transmitted diseases. In such cases, fissures are usually multiple and may have an atypical appearance.
- Acute fissures (usually present for 6 weeks or less) are superficial with sharply demarcated edges.
- Chronic fissures (present for more than 6 weeks) are usually deeper and may have secondary features, including hardening of the edge of the fissure, a sentinel pile which looks like a small skin tag, and hypertrophied anal papillae, etc.
Homeopathic Treatment for Fissure
Fissure-in-ano (anal fissures) finds an excellent treatment with homeopathy. Most cases heal with medicines and surgery can be avoided.
The Dr Shah's Homeopathy Treatment
Dr Rajesh Shah, M.D. has researched on a wide range of chronic diseases including Fissure-in-ano, for over 20 years. His research-based molecules have international patents (pending as well as granted). His unique treatment protocol is made available to patients world over. At this point, there are patients from 180 countries under Dr Shah's care, which has been a world record.
The duration of treatment for Fissure-in-ano:
Most patients show significant improvement in about three to four weeks, in case of fissure-in-ano. The full length of treatment is usually for about four months. Some patients may need longer course of medication.
It is possible to avoid surgery in most cases if timely homeopathic treatment is used.
How to get started with treatment with Dr Shah?
Dr Shah's online treatment works on simple 3 steps. Please click here for more details.
Future of Fissure
Prognosis:
The vast majority of acute fissures resolve entirely within a short span of time, if there is no constipation or straining for the toilet.
Complications:
If acute fissures are not properly managed, they become chronic. Chronic and non-healing fissure-in-ano may present as a complicated condition, especially when it is associated with resistant constipation,
01 Hemorrhoids (piles): Hemorrhoids are swollen, dilated veins of the rectum or anus. Hemorrhoids may be located at the beginning of the anal canal (internal hemorrhoids), or at the anal opening (external hemorrhoids).
02 Anorectal fistula: Anorectal fistula is a hollow tract (opening) leading from the anal canal or rectum to the skin through which watery pus drains.
03 Crohn's disease: Crohn s disease is a chronic inflammatory process primarily involving the intestinal tract. It most commonly affects the last part of the small intestine (ileum) and/or the large intestine (colon and rectum). Also called regional enteritis and ileitis.
04 Anorectal cancer: Cancer affecting rectum and anus.
05 Perianal abscess: Perianal abscess is a collection of pus outside the anus.
Chronic and recurring fissures may lead to permanent scarring or injury that prevents normal bowel movements.
Timely administered homeopathic medicines take care of acute and chronic fissures gently, effectively, and without producing any side effects.
Self Help For Fissure
01 Diet - As constipation is the main culprit behind fissure-in-ano, all steps to avoid constipation will help to a great extent. A high-fiber diet and extra fluids to prevent constipation are recommended. This means eating more fruits, vegetables, cereals, wholemeal bread, etc. and drinking at least 8 glasses (12 cups) of water a day. Reduced intake of coffee and alcohol also helps.
02 To relieve pain Apply a warm towel to the area. Warm baths or Sitz baths also relieve pain. Use 8 inches of warm water in the bathtub, 2 or 3 times a day for 5-10 minutes. Do not expose the anal skin to hot bath water or hot shower water. Use only luke-warm water in this area.
03 Physical activity - No restrictions are necessary. In fact, physical activity reduces the likelihood of constipation.
04 To prevent infection, gently clean the anal area with soap and water after each bowel movement. Do not put any creams or ointments, cornstarch, talcum or other powder, witch hazel, or anything else on or into the anus.
05 To prevent recurrence - 1. Avoid constipation by drinking at least 8 glasses of water daily and eating a diet high in fiber. 2. Develop a regular bowel habit. Do not suppress the desire of passing stools as this results in hard and large stools, which usually produces injury to the anus. 3. Avoid straining at stools. 4. Avoid anal intercourse