An anal fissure is a tiny cut or a tear in the thin tissue (mucosa) that lines the anus. An anal fissure may happen when you pass hard or massive stools during a bowel movement. Anal fissures can be common in infants but affect people of any age. Natural treatments can help.

What is anal fissure?

An anal fissure is a tiny cut or a tear in the thin tissue (mucosa) that lines the anus. An anal fissure may happen when you pass hard or massive stools during a bowel movement. Anal fissures typically cause bleeding and pain with bowel movements. You could also experience spasms from the ring of muscle at the end of the anus (anal sphincter).

Anal fissures can be common in infants but affect people of any age. Most anal fissures get better with simple remedies, such as increased fiber consumption or sitz baths. Some individuals with anal fissures may require medication or, sometimes, surgery.


See: Case of Anal Fissure Escapes Surgery with Ayurvedic Remedy

Anal fissure symptoms

Symptoms of an anal fissure include:

- Pain during & after bowel movements

- A small lump on the skin near the rectal fissure

- Bright red blood marks on the stool or toilet paper after a bowel motion

- A visible crack on the skin around the anus

See your doctor if you have pain or notice blood on stools or toilet paper after a bowel movement.

See: Acupuncture helps a Case of Hemorrhoids

Anal fissure causes

Frequent causes of a rectal fissure include:

- Passing large or hard stools

- Constipation and straining during bowel movements

- Chronic diarrhea

- Anal sex

- Childbirth

Less common causes of rectal fissures contain:

- Crohn's disease or another inflammatory bowel disease

- rectal cancer

- Tuberculosis

- Syphilis

- HIV


See: Ayurvedic Therapy to Help Heal Hemorrhoids

Risk factors & complications

Factors that can raise your risk of developing an anal fissure include:

- Constipation: Exerting pressure and straining during bowel movements and passing hard stools raise the chance of tearing.

- Childbirth. Anal fissures are more prevalent in women after delivery

- Crohn's disease. This inflammatory bowel disease can cause chronic inflammation of the intestinal tract, which might make the anal canal lining more vulnerable to tearing.

- Anal sex.

- Age. Anal fissures are more common in babies and middle-aged adults but can happen at any age.


Complications of anal fissure can include:

- Struggling to cure. An anal fissure that does not heal within eight months is considered chronic and may require additional treatment.

- Recurrence. As soon as you've experienced an anal fissure, you're prone to getting another one.

- A tear that expands to surrounding muscles. An anal fissure may develop into the ring of muscle, which holds your anus closed (internal anal sphincter), which makes it more challenging for the anal fissure to heal. An unhealed fissure can cause a cycle of distress that may require surgery or medications to decrease the pain and to fix or eliminate the fissure.

See: Diet to Eliminate Hemorrhoids with Success

Anal fissure natural & home treatments

How can it be treated naturally?

Many short-term anal fissures can heal with home remedies and treatment in 4 to 6 weeks. Pain during bowel movements usually goes away in a few days after the beginning of home therapy.

The treatment can vary from patient to patient and appears to be partly dependent upon how well they follow the treatment program. Patients will frequently stop the treatment once their pain level has decreased, but until complete healing has occurred. Patient education concerning the recovery process and what could be expected through its course is quite essential for effective treatment. Regular follow-up is required to evaluate the recovery process and reassure the patient. Once healing has occurred, keeping proper bowel function and good gut and dietary habits are essential for the prevention of further episodes.

There are different actions one can take to alleviate your symptoms and help the fissure cure:

Try to prevent constipation

- Include beans, whole grains, fruits, vegetables, in your diet every day. These foods are high in fiber.

- Drink lots of fluids.

- Get some exercise daily.

- Require a fiber supplement daily if necessary.

- Use the bathroom when you feel the impulse. Or when you are able to schedule time every day for a bowel movement. A daily routine can help. Don't rush, and don't worry when having a bowel movement. But don't sit on the toilet for a long time.

- Try taking stool softeners or laxatives to make bowel movements less painful. Ask your health expert how long you need to continue to take laxatives.

- Sit in a tub full of a few inches of warm water for 20 minutes, two or three times a day. This is referred to as a sitz bath. It soothes the torn tissue and helps relax the internal anal sphincter. Do not place additives, additives, or shampoos from the water.

Speak with your physician about whether to try a nonprescription cream like zinc oxide, Preparation H, Anusol, or 1 percent hydrocortisone for a brief time. These can help soothe anal tissues. But fiber and sitz baths help symptoms longer. 

- Rather than using toilet paper, use baby wipes or treated pads, such as Tucks pads or Preparation H wipes, to wash after a bowel movement.

- Do not avoid having bowel movements. Knowing that it may hurt may make you anxious. But trying not to have bowel movements will only make constipation worse and maintain the fissure open and debilitating.

What happens if the fissure does not heal by itself?

Approximately 9 out of 10 short term fissures heal with home treatment--such as using stool softeners or fiber supplements and taking routine sitz baths. And about 4 out of 10 long-term anal fissures will heal after home treatment is utilized.

However, not all fissures will heal with only home therapy. If a fissure lasts longer than 8 to 12 weeks, you might need prescription medicines. These could include nitroglycerin cream, higher blood pressure medications in pill or gel form, or injections of botulinum toxin (Botox).

If medicines do not stop your symptoms, you might need to think about surgery. The most widely used operation is a lateral internal sphincterotomy. In this process, a doctor cuts into part of the internal sphincter to relax the strain that's causing the fissure.

See: Magnesium for constipation relief

Ayurveda treatment for anal fissure

Effective ayurvedic therapy for anal fissure. 

- Ayurveda advises internal medication in addition to topical ointment application in the treatment of anal fissures. To avoid further irritation to the tissue that is damaged, medicines that soften the stools and encourage healing of the cells are utilized. Ointments that are naturally anti-bacterial and anti-septic are used for topical application. In addition, we run Agnikarma, a para surgical process. This is thermal cauterization. In this process, sentinel tags are removed by thermal cauterization, and sphincterotomy also will be carried out by Agni karma to decrease the spasm of the anal ring. These Ayurvedic medications reduce pain, itching, burning, and discomfort in the anorectal area. This therapy accelerates the healing process and helps you to eliminate anal fissure.

According to Ayurveda, this condition relates to the annoyance of Vata and Pitta Dosha. So, we will need to treat according to these doshas. We also require a medication that induces quick recovery. We can split the treatment into two main classes:

- External Application: Jatyadi Oil, Pilex Ointment, Pilief ointment. These three medications provide almost similar results. But, Jatyadi Oil has a much better outcome once we compare treatment length. It assists in rapid healing than others.

- Internal Medicine: Yashtimadhu Churna 2 grams, Gandhak Rasayana 500 mg, Rajat Bhasma 125 mg, Triphala Guggulu 1 gram. Yashtimadhu Churna pacifies Vata and Pitta Dosha. Aggravation of these doshas is mostly responsible for anal fissure. Additionally, it helps to accelerate the healing process of this fissure. Gandhak Rasayana has sexy potency, but its effectiveness Relies on other Yashtimadhu. It's required to heal the fissure and stop the infection. Rajat Bhasma reduces pain associated with anal fissure. It also acts as antimicrobial and prevents infection. The primary purpose of using Triphala Guggulu from the anal fissure is its analgesic and anti-constipation action. However, it's also moderately warming in character, but Yashtimadhu balances its warming action. It serves the purpose of decreasing constipation, softens the stool, relieves pain, and prevents disease.

- Homeopathic remedy

An anal fissure is a frequent finding in patients presenting with rectal pain and is often associated with internal hemorrhoids. While there are just a few allopathic remedies for anal fissure, this problem is very responsive to treatment with various natural medicines. Initial treatment must be to relieve the pain and pain, as often this is what's brought them to your workplace. Homeopathic medicines can be considered for this as they provide immediate relief and will aid the healing process. 

- Other remedies:

Often patients have inadequate bowel movement procedures and may be in need of instruction. The patient should be instructed not to strain during the passage of feces and to use cotton balls moistened with water as opposed to toilet paper, chemical, or alcohol wipes. 

- Wipes: Over-the-counter wipes that contain alcohol and compounds break down the skin's protective barrier, which makes recovery more challenging and disease more likely. Some individuals are excessive cleaners, and they ought to be instructed that it's unnecessary to wash deep into the anal canal, as this can make the condition worse. Furthermore, leaning forward with the passage of feces allows for a change in the rectal angle and a more comfortable passage.

- Sitz baths also assist in the healing process by providing increased blood circulation to the area. If doing a sitz bath is not possible, alternately spraying warm and cold water on the perineal area will attain the same outcome.

- Fiber: Increasing dietary fiber is essential if the condition is because of chronic constipation, whereas chronic diarrhea can be managed via many different therapeutic approaches once the cause is found. 

- Diet: Diet changes are a must, mainly if the rectal fissure is related to irritable bowel or Crohn's disease. Higher rates of hemorrhoids and Crohn's disease are observed in blood group O individuals and are believed to be caused by food intolerance. 

See: Homeopathic medicines for constipation, gas & bloating

Anal fissure prevention

You may have the ability to avoid an anal fissure by taking steps to prevent diarrhea or constipation. Drink fluids, eat high fiber foods, and exercise regularly to keep from having to strain during bowel movements.

See: Ayurvedic Approach to Gut Health & Constipation

References

https://www.uofmhealth.org/health-library/uf4764

Mayo Clinic https://www.mayoclinic.org/diseases-conditions/anal-fissure/symptoms-causes/syc-20351424


See: Foods to avoid when constipated

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