Anal Fissure
325 Case Studies
42 Member Stories
23 Research

An anal fissure is a thin tear, crack or cut in the anal mucosa. Ayurveda provides effective integrative therapies for anal fissure. Ayurvedic medications can help reduce pain, itching, burning, and discomfort in the anorectal area and help you to eliminate anal fissure.

What is an anal fissure?

An anal fissure is a thin tear, crack or cut in the anal mucosa. It's characterized by pain, distress whilst bowel movement, itching, bleeding, and burning after defecation. Ano-rectal disorders can affect people of all ages, from young babies to seniors. Among all anorectal ailments, hemorrhoids or piles, anal fissure, and fistula are the most frequent. Piles is characterized by bleeding and prolapsing of the anus during defecation. Fissures are tears in the rectal tract caused because of passing hard stool. Fistula is a pus-filled cavity in the rectal tract. In all anorectal ailments, digestion is a significant concern together with sluggish digestion. Other common causes include excessive indulgence in sexual activities, physical strain, consuming non-vegetarian, and drinking alcohol. 

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. Ayurvedic remedy for anorectal disorder provides encouraging results with personalized medications, lifestyle, and diet recommendations. Ayurveda provides effective integrative therapies for anal fissure. Ayurvedic medications can help reduce pain, itching, burning, and discomfort in the anorectal area. This therapy accelerates the healing process and helps you to eliminate anal fissure.

See: Ayurvedic herbs for constipation relief

Who's at risk for an anal fissure?

Anal fissures are common during infancy. Older adults are also prone to rectal fissures due to diminished blood flow in the anorectal area. Women are at risk for anal fissures during and after childbirth, because of straining during delivery. People with IBD have a higher risk of developing anal fissures. The intestinal lining inflammation makes the tissue around the anus more prone to ripping. Individuals who often experience constipation are at a higher risk for anal fissures also. Straining to pass large & hard stools is the most frequent cause of anal fissures.

How is an anal fissure diagnosed?

A physician can usually diagnose an anal fissure by merely examining the area around the anus. However, they might want to do a rectal examination to confirm the diagnosis. In this test, the doctor may insert an anoscope in your anus to make it easier to find the tear. This medical device is a thin tube that allows doctors to inspect the anal canal. Using an anoscope can also help your doctor find other causes of rectal or anal pain, such as hemorrhoids. In some instances of rectal pain, you might need an endoscopy for improved evaluation of your symptoms.

See: Low FODMAP Diet For Irritable Bowel Syndrome IBS Relief

Ayurveda approach to anal fissure

Ayurvedic treatment for anal fissure relies on finding the root cause of the problem. Unlike other therapy procedures that jump directly to symptom management, Ayurveda intends to deal with the root cause of this disease. It starts by massaging the body so that medications can work better towards treating the true root-cause of this disease. Aside from medicines, lifestyle and diet play an extremely significant role in complementing the impact of medication in addition to sustaining the benefit of therapy after the medications have ended. Ayurveda equally focuses on your diet & lifestyle. Since Ayurveda concentrates on the root cause of this disease, it effectively reduces the risk of severe health complications stemming from the untreated underlying cause. Patients who complete their Ayurveda therapy have a reduced risk of health complications afterward.

How Ayurveda Can Help? 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.


See: Ayurvedic Approach to Gut Health & Constipation

Ayurvedic treatment for anal fissure

How is an anal fissure treated in Ayurveda?

Hemorrhoids: Ayurveda segments Hemorrhoids or piles in four grades from 1 to 4 in increasing order of sophistication of conditions. Grade I could be treated with ayurvedic herbs to enhance Agni (digestion)and to control bleeding when it's present. The treatment works on normalizing natural bowel movement. For Grade II, Ayurveda treatment focuses on improving Agni. No surgical intervention is essential at this stage. Specialized herbs are prescribed to decrease inflammation and expansion of the hemorrhoids mass. Grade III is regarded as an advanced stage where the pile mass needs to be eliminated with the Ayurvedic Kshar Sutra technique. Ayurvedic herbs are given to cure the anus as well to avoid recurrence. Finally, in grade IV, along with bleeding as well as the typical symptoms, the piles mass prolapses and causes severe pain and distress. Taking away the piles mass is the principal focus of this treatment at this stage, together with medications to treat the root cause.

Fissure: Ayurvedic therapy for fissure is focused on lessening the strain on the rectal tract by relieving bowel movement, healing internal scars in addition to reducing Vata, and balancing Agni for proper digestion.

Fistula: In this type of anorectal disorder, Ayurveda provides herbal medications to deal with pus secretion and infections. In addition to herbs, Kshar Sutra assists in removing the abscess and minimizing the risk of further infections.


See: Ayurvedic Treatment For Hemorrhoids or Piles

Ayurvedic herbs for anal fissure relief

While Ayurvedic medicines for piles do exist, correction of metabolic errors and lifestyle modification is the secret to curing piles. Charting out a nutritious diet program and weeding out dangerous activities from your everyday routine can slowly help individuals with piles and fistula recover naturally. Ayurveda has identified a lot of natural and herbal ingredients that have shown to function as a remedy for piles. Many Ayurvedic proprietary oral nutritional supplement is to healing the root cause that contributes to piles, anal bleeding, and hemorrhoids. A unique mix of elephant foot yam and touch-me-not plant with extracts of Turmeric, Chitrak, Guggulu and Triphala, makes these versions effective ayurvedic medicine for heaps and fistula.

These herbs regulate your metabolism with a gentle laxative action and help facilitate easy bowel movement. Standard intake reduces pain, promotes shrinkage of heap density, and speeds up recovery. Touch-me-not plant is a recognized ayurvedic herb to treat bleeding piles. It contains alkaloid mimosine, which alleviates pain and reduces inflammation. The phenolic content and antioxidant activity of the plant accelerates wound healing. In the ancient periods, Ayurvedic doctors prescribed a decoction made with touch-me-not plant to treat piles.

See: Turmeric Curcumin Health Benefits & Side Effects

Other natural treatments for anal fissure

Most anal fissures do not need extensive therapy. Specific home remedies can promote healing and relieve uncomfortable symptoms. You can treat an anal fissure in your home by:

Using herbal stool softeners and drugs to heal fissures drinking lots of fluids.

Taking a sitz bath to relax the rectal muscles, relieve irritation, and increase blood circulation to the anorectal area.

Eating foods with high fiber like raw fruits and veggies

Taking fiber supplements 

Applying a herbal ointment to encourage blood circulation to the area

If your symptoms are not relieved within two weeks of treatment, see your physician for additional evaluation. Your doctor can be sure that you have the appropriate identification and can recommend other therapies. Another possible remedy is Bastichikitsa, which helps to relieve constipation and increases blood supply to the rectal area. This permits the anal fissure to heal while preventing new fissures from forming. Not all anal fissures are an indication of low-fiber constipation and diets. Poorly healing fissures or people located in a position aside from the posterior and midline part of your anus may signal an underlying illness.

When you have any concerns about a fissure that is not curing despite trying at-home remedies, contact your physician to find out if you will need any additional tests.

See: Ayurvedic Diet

Prevention of anal fissure

How does an anal fissure be avoided?

An anal fissure can not always be prevented, but you can reduce your risk of becoming one by taking the following preventive measures:

- keeping the anal area dry

- cleansing the rectal area gently with mild soap and warm water

- drinking lots of fluids, eating fibrous foods, and exercise regularly to prevent constipation immediately

- changing infants' diapers often

Anal fissures can cause sharp pain and tiny amounts of bright red blood with bowel movements. If it turns into a chronic anal fissure, skin tags may develop in the field related to a chronic regional infection. Seasonal Basti Chikitsa helps to recurrence in anal fissures.

Conditions related to anal fissures incorporate preceding anal surgeries, inflammatory bowel disease, local cancers, and sexually transmitted diseases. Some conditions which may more directly cause anal fissures are ones that cause trauma to the area, such as vaginal delivery, anal intercourse, or passing hard stool.

See: Acupuncture helps a Case of Hemorrhoids

Scientific studies in Ayurveda for anal fissure

Research: To assess the function of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano.[1]

A total of 100 sufferers of chronic fissure-in-ano were selected and randomly divided into two classes (50 in each group). In group-A, patients were experienced by KSS, while in patients of Group-B Lord's anal dilatation followed by KSS was performed under spinal anesthesia. The KSS procedure was done once, and after slough from Ksharasutra, the wound was treated for four months, and evaluation of the outcome was completed on the basis of gradation adopted.

Outcomes: The measure of pain relief on the 14th day in Group-A was 86 percent while in Group-B 100 percent was observed. According to the 7th day in Group-A, oozing was ceased in 68% of patients, while in Group-B, oozing was stopped in 82% of patients. On the 21st day, Group-B revealed more healing (85 percent ) compared to Group-A (69 percent ). In this study, 68% of patients were treated.

Conclusion: In Group-B (KSS procedure with Lord's anal dilatation), patients were treated early compared to patients of Group-A (KSS independently ).

In Group-B (KSS procedure with Lord's anal dilatation), patients had significantly less postoperative pain and were treated early when compared with Group-A (KSS). Healing of postoperative wound was within 21 days in both groups; hence, it can be concluded that there's not any wound infection because of Ksharasutra in addition to per rectal instillation of Jatyadi Taila which assisted in early wound healing. No adverse effect of any medication or untoward effects of Ksharasutra was detected during or following this procedure. Finally, the study concluded that Ksharasutra might be utilized as one of the modalities for treating Parikartika (chronic fissure-in-ano).

See: Diet to Eliminate Hemorrhoids with Success

References

1. Dudhamal TS, Baghel MS, Bhuyan C, Gupta SK. Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika (chronic fissure-in-ano). Ayu. 2014;35(2):141–147. doi:10.4103/0974-8520.146219

2. Sushruta, Sushruta Samhita, Chikitsa Sthana. Vamana-Virechan Vyapada Adhyaya, 34/37. In: Shastri A, editor. 12th ed. Varanasi: Chowkhambha Surabharati Sanshtan; 2001. p. 147. [Google Scholar]

3. Bhuyan C, Dudhamal TS, Gupta SK. A new technique for the treatment of Jeerna Parikartika w.s.r to chronic fissure-in-ano. Indian J Anc Med Yoga. 2010;3:133–40. [Google Scholar]

4. Sharma KR, Sharma SK, Deshpande PJ. Conservative treatment of fissure-in-ano. Nagarjuna. 1973;XVI:56–8. [Google Scholar]

5. Bhuyan C, Dudhamal TS, Gupta SK, Jaiswara S. Effect of Ksharakarma in Parikartika (acute fissure-in-ano) Indian J Anc Med Yoga. 2009;2:65–75. [Google Scholar]

6. Anal Fissure. (2017, March 23)

https://www.fascrs.org/patients/disease-condition/anal-fissure-0

7. Anal fissure. (2017, March 23)

http://www.nhs.uk/conditions/Anal-fissure/Pages/Introduction.aspx

8. Klein, J. (2014, May). Common Anal Problems [Abstract]. Medical Clinics, Volume 98, Issue 3, Pages 609–623

http://www.medical.theclinics.com/article/S0025-7125(14)00013-3/abstract

9. Solomon, M., Smith, S. Review: medical therapies are less effective than surgery for anal fissure. BMJ Journals

http://ebm.bmj.com/content/9/4/112.full

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