An anal fissure or fissure-in-ano is a small, cut in the skin in anal passage which results because of trauma to skin by passing hard stool in this region. Sometimes pain is so severe that patient tends to avoid passing stool in an attempt to stay away from pain.

Symptoms of Anal Fissure: 

  Pain in anal region while passing stool; it may be burning/pricking/Itching in nature.

  Bleeding may or may not be there.

  If untreated for long time; a skin tag known as Sentinel tag or Sentinel Piles develops from the lower end of fissure.

Causes 

The causes related to the emergence of an anal fissure include:

  Passing hard stool which causes frictional injury to inner lining of anal passage.

  Repeated bowel movement or diarrhea

  Trauma to anal canal like by enema nozzle 

Why non surgical treatment is better than Surgery:

Usually surgery (Lateral sphincterotomy) is advised in a view to relieve spasm in anal region so that Fissure starts healing but there are certain complications like stool incontinence etc. associated with this procedure which makes non surgical approach better than surgical intervention. Some of the reasons which make non surgical approach better than surgery for anal fissure are as follows: 

  Acute anal fissure can be conveniently treated by Graded Kshar Karma Treatment. In this treatment a specialized Ayurvedic medicine is applied in fissure region which debrides the fissure and promotes healing. In this way fissure heals completely. So, no need for any surgery at this stage and thus no complication like bleeding, pain, stool incontinence, etc.

  When Fissure is not treated at this stage; a skin tag known as sentinel piles develops from the lower end of fissure. This condition also can be managed by Graded Ksharsutra TM Treatment. In this treatment, Graded Ksharsutra TM - a specialized medicated thread is ligated at the root of sentinel piles and sentinel tag gets detached in 3-5 days. No hospitalization or bed rest is required in this treatment. So, at this stage also fissure can be managed without surgery.

  Delayed healing and Recurrence of Anal fissure are other complications seen after Anal Fissure surgery. Such complications are not seen in Graded Kshar Karma and Ksharsutra Treatment.

  In some case stool incontinence (inability to hold stool; which is far worse than Anal fissure itself) is also seen after Anal Fissure surgery. However, there is no harm to stool control in Graded Kshar Karma and Ksharsutra Treatment.

  No hospitalization or bed rest is required in Graded Kshar Karma and Ksharsutra treatment. Hospitalization and bed rest for a considerable time period is necessary in surgery.

  Graded Kshar Karma and Ksharsutra are more economical than surgery. With this discussion; it is for sure that non surgical treatment for Anal Fissure is far better than Surgery.

Anal Fissure - Non Surgical Treatment Is Better Than Surgery!

It is a slowly and gradually progressing disease in which healthy liver tissue is replaced with scar tissue, hence preventing the liver from proper functioning. The developed scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver. Cirrhosis is a complication of liver disease which involves loss of liver cells and irreversible scarring of the liver. In other words, Cirrhosis is a condition in which the liver does not function properly due to long-term damage. Typically, the disease comes over months or years.

Although there are many other causes for cirrhosis, the commonest is excessive use of alcohol, viral hepatitis B and C infections and non-alcoholic fatty liver disease. Thus the scarring is most often caused by long-term exposure to toxins such as alcohol or viral infections.

According to the National Institutes of Health, it is the 12th leading cause of death. Men are more prone to develop cirrhosis than women. Globally approximately 57% of cirrhosis is attributable to either hepatitis B (30%) or hepatitis C (27%).Alcohol consumption accounting for about 20% of cirrhosis.

Persons most commonly affected: Adults of both sexes.

Unani approach to Cirrhosis of Liver (Talayyuf-e- Kabid)-

In Unani literature Cirrhosis of the liver is known as  Talayyuf-e- kabid ,  Sighr-al- kabid  or  Jigarki laghari . It is of two types.

1. AcuteType of Cirrhosis of Liver (Talayyuf-e- Kabid Hadd)-

It is rare but very dangerous. It is also called Yarqaan-e- khabees or Huzaal-e- asfar. Mainly occurs due to inflammation in hepatic cells, in which hepatic cells squeeze in few days resulting in improper functioning of liver. It is a disease in which cells throughout the liver are destroyed. Although they are replaced by areas containing normal new cells but also by much scar tissue, which alters the structure of the liver.

Causes and risk factors: Excessive use of alcohol/ chronic alcoholism, poor nutrition, highly toxic condition of the body system, viral infections caused by chronic viral hepatitis (types A, B and C), metabolic diseases such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders,inherited diseases such as Wilson's disease and hemochromatosis, biliary cirrhosis, toxic hepatitis due to severe reactions to prescription drugs or prolonged exposure to environmental toxins and repeated bouts of heart failure with liver congestion etc.

Signs and Symptoms: The main signs and symptoms of this type are jaundice, pain at the site of liver, vomiting, headache, dizziness, increased body temperature, increased pulse rate, brownish coloured and dry tongue, increased thirst, initially whitish coloured diarrhoea, later on, colour becomes blackish due to contamination of blood, urine passes in less quantity and reddish in colour due to contamination of yellow bile in it,  haemorrhage from nose, stomach, intestine and uterus even abortion in women are seen. The size of the liver feels small on palpation.

2. Chronic type of Cirrhosis of Liver (Talayyuf-e- KabidMuzmin)

This type of the disease occurs due to the improper blood supply to the hepatic cells resulting in the size of liver very small in appearance but liver cells stay normal.

Causes and risk factors: The main causes of this type are the application of permanent pressure at the site of the liver such as ascites, alcohol abuse, hepatitis C virus infection, cardiomegaly, poor nutrition, highly toxic condition of the body system, peritoneal inflammation, improper diet in old age and starvation etc. Other causes which develop this disease are, obstruction of the external bile duct by stone, scar, inborn defect or tumour, use of certain medications, syphilis and passive liver congestion. Obesity has recently been recognized as a risk factor in non-alcoholic hepatitis and cirrhosis.

Signs and Symptoms: It is a slowly progressing disease. In early-stage symptoms, of indigestion like flatulence, constipation and diarrhoea may be present. General weakness, the feeling of being unwell, loss of appetite, loss of weight, and a loss of interest in sex may also be there. There may be a dull abdominal ache, nausea and vomiting. Eventually, the patient dies due to anaemia or ascites. The feeling of dullness is the peculiar sign of the disease. Other symptoms and signs include low-grade fever, bad breath, jaundiced skin and bloated and swollen abdomen.

Complications and Risks associated with Cirrhosis of Liver (Talayyuf-e-Kabid)-

Ascites (retention of fluid in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from oesophageal varices. Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis, the only option is a liver transplant.

Preventive measures for cirrhotic patients (Talayyuf-e- Kabid ke Mareezon ke liye Ehtiyaati Tadaabir):

Cirrhotic patients must completely avoid alcohol. Alcohol accelerates liver failure and hastens death in cirrhotic patients.
Avoid liver toxins. Acetaminophen (Tylenol), should be avoided because they can be toxic in cirrhotic patients.
Juice therapy helps the liver to detoxify toxins from the body. Cirrhotic patients should mix one part of pure juice with one part of water before drinking.
Cirrhotic patients are strongly advised to eat smaller meals. To avoid overworking the liver, five or six smaller, lighter meals per day are recommended.
Avoid fatty foods and processed foods, especially foods prepared with animal fats or hydrogenated oils. These types of foods put additional load on the liver.
Cirrhotic patients are also advised to eat only lean proteins (containing no fats) and in limited amounts.
Vegetable proteins are very beneficial in Cirrhotic patients. High protein intake causes increases of ammonia levels in the blood, possibly resulting in mental confusion, and in severe cases, coma. However, do not severely limit protein intake, as this may cause protein deficiency and impair the healing process.
Routinely increase consumption of fruits and steamed vegetables as fruits and vegetables are easy to digest, thus less work for the liver. In addition, they are good sources of vitamins, minerals, and antioxidants that help the liver detoxify and heal.
Cirrhotic patients are advised to practice intermittent fasting.
They are also advised to protect against hepatitis B, C and E.
Fundamentals of Management in Unani Medicine-

Identify the cause of the disease and treat it accordingly
Correct the digestive processes
Use hot dresses
Use mild and early digestible diet
In case of ascites treat it
Management/ Treatment-

In Unani medicine, very effective treatment is available for the Cirrhosis of Liver by strengthening the Liver cells and restoring normal size and functions of the Liver. In Unani medicine, there is a number of hepatoprotective drugs that protect the Liver either acute or chronic type.

SootshekharRas Swarna yukta 125 Mg twice a day
PittariAvleh 10 gm twice a Day
Duration of the treatment: 3 to 6 months or it depends upon the condition of the patients. If the patients with cirrhosis have diabetes, then the treatment may take long time for curing the disease. Diet plays a key role along with Unani Medicines. Hence, it is strictly advised to follow a proper diet plan.

Talayyuf - E - Kabid Or Cirrhosis Of The Liver - Know More About It!

Irritable bowel syndrome is a disorder of the large intestine. It may cause abdominal pain, bloating, diarrhea and constipation. The condition is not life threatening in nature and does not make you susceptible to colon disorders such as Crohn's disease, ulcerative colitis and colon cancer, however, symptoms of IBS may act as deterrents in leading a normal life.

Symptoms
The symptoms of irritable bowel syndrome are: 
1. You may experience symptoms of constipation
2. Frequent episodes of diarrhea
3. Abdominal cramps especially on the lower part of the abdomen
4. Constant bloating
5. Abnormal stool structure 
6. You belly might stick out 
In some cases, you may experience sexual problems and urinary problems. In addition, if you also suffer from stress related disorders then it might aggravate the symptoms.

Causes
The primary cause is that the colon becomes very sensitive such that small stimulation may cause it to react. When the food passes through the colon, it tends contract strongly and leads to complications, such as bloating and constipation. It may also lead to weak contractions of the colon which leads to hardened stool.
There are certain things which may symptoms of IBS, they are: 

1. Stress: Any type of stress tends to aggravate symptoms of irritable bowel syndrome.

2. Foods: Certain foods such as chocolate, spices, cabbage, milk and carbonated beverages may trigger symptoms of IBS.

3. Hormones: Hormonal changes such as the ones during menstrual cycles may aggravate symptoms of IBS. 

4. Illnesses: Various illnesses such as diarrhea or conditions such as overproduction of bacteria in the intestines may lead to symptoms of irritable bowel syndrome.

Women are more likely to be affected by symptoms of IBS as are people who are below 45 years of age. If someone in your family has irritable bowel syndrome, then you are also likely to develop this disorder. It may also aggravate symptoms of hemorrhoids, along with aggravating symptoms of stress.

All About Irritable Bowel Syndrome

Peptic ulcer often referred to as stomach ulcer, is usually a misunderstood disease. Most people are unaware of the reasons why the ulcer is caused and are also unaware of the early symptoms of the disorder. Here is a look at some of the strange facts about peptic ulcers that you may not know.

Stress does not cause ulcers: The myth that stress causes ulcers is just that- a myth. Ulcers are not caused by stress and tension. However, if you are already affected by an ulcer, stress can alleviate the symptoms and make matter worse. Non-steroidal anti-inflammatory drugs can result in ulcers. So, if you have already been diagnosed with peptide ulcer, try not to stress too much.
Ulcer pain is not caused due to food: Contrary to popular belief, ulcer pain is not alleviated when you eat something. In fact, the pain increases if your stomach remains empty for a long period of time. So, if you are an ulcer patient, make a point of eating at regular intervals. In fact, the American College of Gastroenterology claims that people with ulcers do not need to follow a bland diet in order to recover from the condition.
Heartburn medication is effective against ulcer: Stomach acid is the common link between heartburn and ulcer, as both of these disorders are caused as a result of excess acid formation in the stomach. This is why physicians often prescribe antacids to ulcer patients.
Untreated ulcers can be problematic: Ulcers are easy to cure and can be completely treated with proper medication and adherence to restrictions. However, you should seek treatment for ulcers as soon as it is diagnosed. If left untreated, this ulcer may go on to cause severe issues for the patient. For instance, untreated ulcers may lead to internal bleeding and scar tissue. The same also impede the digestive process. So, do not leave ulcers untreated and think that they will be repaired automatically over time.
Endoscopy is the best way to diagnose ulcers: Even though X-rays may often reveal ulcers, a normal X-ray cannot detect certain smaller ulcers. Endoscopy is the best way to detect the disorder. In this process, a small tube, containing a light and a camera, is inserted inside the patient s oesophagus. The camera reveals any abnormal growth or infection inside the stomach. If you suspect an ulcer, book an appointment with the doctor as soon as possible.

Strange Things About Peptic Ulcer!

Hyper acidity (Amlapitta) is also called Acid Dyspepsia, which is one of the most common problem. Hyperacidity is a condition in which stomach secretes excess amount of acid.

Hyperacidity is very closely associated to Amlapitta in Ayurveda which is caused by the imbalance of agni or the digestive fire leading to the vitiation of pitta dosha.

Causes of Hyperacidity:

Hurry ,  Worry , and  Curry  are the three main reasons for the disease.

Diet (Ahara)

Spicy fried junk food

Carbonated drinks

Excessive use of chilly, mustard, garam masala powder (spice mixture), garlic etc. in diet

Salty and sour foods like chips

Eating of stale, fermented foods (dosa, uttappa, idli, dhokla etc. bakery food items).

Excessive intake of fast food

Excessive intake of Oily foods, pickles

Excessive intake of tea/coffee.

Lesser intake of water

Irregular meal times

Skipping meals

Repeated food intake (before the digestion of the previously taken food)

Incompatible food like taking non-veg with milk, sour fruits with milk, pizza followed by milkshake

Eating too late at night

Regimens (Vihara)

Lack of rest

Fast moving lifestyle.

Insufficient sleep at night.

Sleeping immediately after meals.

Sleeping in daytime

Mental factors

Stressful lifestyle
Excessive anxiety

Anger

Other causes of acidity include:

Medications: Some anti-inflammatory drugs, when taken for a long period of time can develop chances of hyperacidity.

Drinking alcohol

Smoking

Pregnancy

Obesity

Fasting

All the above factors result in an excessive increase of  Pitta dosha  in the body and exhibits symptoms of amlapitta.

The condition of Amlapitta is explained with a simile just as milk is poured into curd pot immediately attains sourness and gets into an inspissated form. In the same way, repeatedly eaten food gets improperly burnt and causes acidity.

Signs and symptoms

Vomiting

Loss of proper taste of food

Loss of interest of food

Headache

Heart &chest burn (retrosternal burning)

Sour or bitter test in mouth and belching.

Nausea

Throat burn

Regurgitation of food or sour substance

Gaseous distention/ bloating of abdomen

Pain in abdomen

Chest pain

Foul smelling loose motions.

Burning sensation over feet, hands

Mouth ulcers

Fatigue (especially in legs)

Tiredness

Fainting

Ayurveda has explained 2 main types of amlapitta:

Urdhvag Amlapitta: Mainly characterized by vomiting due to upward movement of pitta 

Adhoga Amlapitta: Mainly characterized by loose motions due to downward movement of pitta.

Investigations

If there is chronic hyperacidity, following investigations are useful:

Gastroscopy (Upper Gastrointestinal Endoscopy)

Barium Meal x-ray

Gastrin levels in blood

Serology + histology for H. Pylori

Stool routine examination

Complications 

If not treated at the proper time or if faulty diet, regimen and habits continued, it can complicate as

Gastric Ulcer
Chronic Gastritis
Duodenitis
Prevention

 Prevention is better than cure  it is better to avoid all the causative factors of acid-peptic disorders (amlapitta).

Avoid excessive salty, oily, sour and spicy foods

Avoid heavy and untimely food

Avoid smoking and alcohol intake

Avoid overcooked, stale and contaminated food

Avoid fried and junk food items

Do not skip meals

Avoid fast

Do not overeat

Avoid untimely and irregular food habit

Avoid foods containing excess amount of garlic, salt, oil, chilies etc. very often.

Avoid toor dal, horse gram, fenugreek

Avoid lying down immediately after food

Avoid, smoking, alcohol, tea, coffee and aspirin type drugs

Follow the meal times

Take Light food, Coconut water, articles having cooling properties

Take vegetables like white pumpkin, cucumber, leafy vegetables except Methi

Take Wheat, old rice, green gram

Fruits like gooseberry, dry grapes (black resins), black grapes, pomegranate, fig, dry fig, custard apple.

Take adequate amount of fluids like pomegranate juice, amla juice, kokam syrup.

Medicated water with ushir (wala) or coriander-cumin seeds or tulsi seeds (sabja) or laja (puffed rice). 

Take Warm water.

Take Moravla (jam made from amla), gulkand (jam made from rose petals) 

Take One teaspoonful of ghee with warm milk

Take adequate sleep

Exercise regularly

Avoid stress

Follow mental relaxation techniques like meditation, Yoga and Pranayama

Medical management

As the disease is of Pitta origin, all measures are undertaken to pacify pitta.

Some important drugs useful in Amlapitta

Shatavari, Yashtimadhu, Amalaki, Sunthi, Guduchi, Ushir, chandan shankhabhasma, suvarnamakshik bhasma, pravalpishti, sariva, bhunimb etc

Some important Ayurvedic Medicinal Preparations are helpful when taken under proper guidance

Kamdudha Rasa 

Sutashekhar Rasa 

Prawal Panchamrit 

Shankh vati

Bhoonimbadi kwath

Avipattikar Churna

Shatavarighrit etc

'Panchakarma procedures' like Vamana (induced vomiting) or Virechana (induced loose motions) whichever is needed as per the symptoms should be administered. In chronic cases, Asthapana basti (medicated enema) is indicated.

Hyperacidity And Ayurveda!

Dealing with liver Cirrhosis largely depends on its stage. While it is good to know and read about Cirrhosis, referring to some qualified medical personnel is the best course of action. If a person is already undergoing medical treatment, there are simple ways to deal with this condition.

Get treated in the early stages: Liver being one of the most self-healing organs, a person has good chances of healing, if a donor donates partial-liver. A doctor eradicates the distorted portion of the liver and replaces the same with a partial transplant from the donor. For the donor, it takes about 3-4 months to grow back the donated portion of the liver, while the patient might take 10-12 months to fully recover. This is possible in the early stages of Cirrhosis.
Stop the catalyst of liver Cirrhosis: It is essential to stop the underlying cause of Liver Cirrhosis. Stuff like saturated fat, alcohol, salt, OTC pain relievers, excess sugar etc should strictly need to be avoided to ensure the progression of liver Cirrhosis is slow. Studies have shown that moderate consumption of coffee can help to deal with Liver Cirrhosis.
Sodium free food: It is advised by most doctors that Cirrhosis patients refrain from consuming sodium-rich food. It helps a cirrhosis patient to bypass edema and ascites. This is extremely challenging, since food without sodium tastes bland and unappetizing. It is therefore suggested that healthy herbs, paprika, pepper etc are consumed to make up for sodium.
A balanced diet: A liver Cirrhosis patient should be extremely careful when it comes to choosing the right diet. They should consume lots of fresh fruits and green vegetables. While consumption of animal protein is not advised, the quota of protein should be fulfilled from peas, tofu, quinoa, etc.
A good exercise regime: Patients with liver Cirrhosis should ensure that an adequate exercise regime is followed so that the muscles do not get wasted. Exercise for half an hour also helps to lose weight and negate the chances of water retention in the body. Exercise should also be followed by lots of sleep, so that the body gets enough time to recover from the stress of exercise.
Avoid NSAIDs: If a person is suffering from liver Cirrhosis, using drugs such as naproxen, aspirin, ibuprofen, acetaminophen etc should be strictly avoided for mild pain and inflammation. These drugs can be highly toxic for a person suffering from Cirrhosis. It is wise to consult a doctor before consuming any medication.
Stay away from infection: A patient with liver Cirrhosis suffers from a compromised immune system. It is therefore advised that a patient stays away from possible bacteria, viral and such other chronic infection. Any infection can result in inflammation of the bile duct that causes scarring of the liver tissue.

Liver Cirrhosis - 7 Ways To Deal With The Problem!

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