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Anal Fissure - Symptom, Treatment And Causes

Anal fissure occurs because of a tear or cut in the anus, that extends up into the anal canal. Anal fissures are a common condition that happens with many people across the globe and are responsible for 6-15 patient percent visits to a colorectal surgeon.

Anal fissure can happen to anyone. Both men and women, young and old are affected with this malady. Fissure in the anal tract causes severe pain during defecation and bowel movement. In fact fissure in the anus, is the most common cause of rectal bleeding during childhood and infancy. Anal fissures typically happens in the specialized tissue that lines the anal canal and anus, known as anoderm. Unlike skin, anoderm do not have sweat glands, hairs or sebaceous glands. But it has a plethora of sensory nerves that can even sense light touch and pain. This abundance of nerves in the anoderm tissue is what makes anal fissures so painful. This most sensitive anoderm moves up for the entire length of the anal canal till it ends and meets the demarcating line where the rectum starts, which is known as the dentate line.

Anal fissures are caused owing to trauma in the anal canal or in the anus. The most common cause for this trauma is bowel movement. So anal fissures can always be caused by repeated episodes or diarrhea or hard stool (constipation). Many a time insertion of an enema tip, rectal thermometer, ultrasound probe (for examination of the prostate), and endoscope can result in enough trauma for development of an anal fissure. During childbirths, trauma in the perineum tissue, can also cause a tear that can extend into the anoderm. The most common location where this disease is diagnosed is the part of the anus, which is closest to the spine.

Other causes for development of this malady are infectious diseases are viral infections like herpes, gonorrhea, syphilis, chancroid, chlamydia, tuberculosis and HIV. Also patients who suffer from Crohn’s disease, 4% of such patients develop anal fissures as the primary manifestation of their disease. Anal fissures are diagnosed by physical examination of the patients. In case rectal bleeding is present sigmoidoscopy and colonoscopy are done at times to confirm the diagnosis. Even in the case of acute fissures, non-operative therapies proves successful in majority of the patients. Initial treatment of this painful colorectal disease involves prescribing stool softening medications, followed by increase in liquid intake and sitz bath.

Sitz bath increases the flow of blood to the anus, which relaxes the rectal spasm and cleans the anus without irritating the anoderm, if done particularly after passing of the stool.

Treatable by medical professional Require medical diagnosis Lab test required Short-term: resolves within days to weeks Non communicable
Blood in stool Constipation Itchiness around the anus

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Fistula is an infective disease of anal canal which can not be cured by antibiotics as it always have an internal opening in anal canal. So, it requires some form of surgical treatment. With advancement of technology and better understanding of the disease, now various minimally invasive or non invasive procedures are available for fistula treatmenr like plig, lift, clip, vaaft tropis. At sarvottam surgical hospital, a centre of excellence for advanced minimally invasive procedures for piles, fissure, fistula prolapse, all procedures are day care with better results. There are no dressings required and patient can start working within 3-4 days. There is no fear of incontinence.

Fistula-In-Ano (Say No to Surgery) - 7 Important Things You Must Know!

Dr. S K Singh 87% (109 ratings)
M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
Fistula-In-Ano (Say No to Surgery) - 7 Important Things You Must Know!
Anal fistulas or fistula-in-ano generally cause discomfort due pus or watery discharges and sometimes pain. This is a condition where a nodular swelling appears in area surrounding the anal opening. Intermittent pus discharged is noticed from this nodular swelling. Instead of a nodular swelling; there might be simply an opening in this region. An anal abscess is one of the most common causes for this condition. Here are ten things you should know about these anal fistulas: It is curable through Ayurveda only: Till date many treatment options are tried to cure Anal Fistula which include Anal Fistula Surgery/ Glu technique/ cutting seton/ Colostomy/ Fistula plug/ VAAFT and many more. But all of these treatment methods have pretty high recurrence rate of about 20-25 %. However with Ksharsutra treatment for Anal Fistula; chances of recurrence are negligible. Other complications generally seen in surgery like bleeding, incontinence (inability to hold stool); are not seen with Ksharsutra Treatment. Clinical trials conducted by Indian Council for Medical Research (ICMR); at AIIMS New Delhi and PGI Chandigarh in 1992 have proved that Ksharsutra treatment is more convenient and more effective than Surgery in the patients of Anal Fistula. There are symptoms you can look out for: Some of the symptoms that indicate anal fistulas include appearance of a nodular swelling in area surrounding Anal opening. Intermittent pus discharge is also observed from this swelling. Usually pain subsides and opening closes after the discharges; and patient feels relief. But after certain interval of time again pus accumulates; swelling re-appears with some amount of pain which is again relieved after the discharge. This cycle is repeated at varying interval in the patient of anal fistula. Medication can only provide temporary relief: Anti biotics and painkiller might give temporary relief from the symptoms. But after some time there will be again pus formation and associated swelling & pain in area surrounding anal opening. Anal fistulas can recur after surgical treatment: As discussed above all the treatment options tried by modern medicine (including most recent treatment VAAFT) have high incidence of recurrence (about 20-25%) Whereas there are negligible chances of recurrence after Ksharsutra Treatment for Anal Fistula. . Anal fistulas treated by Graded Ksharsutra do not recur: Ayurvedic treatment for anal fistulas is known as Kshar sutra therapy. This involves the use of medicated thread being ligated in Fistula Tract. The medicines present in this thread act as a strong debriding agent and induces healing of Fistula tract. In few weekly sittings of Ksharsutra change; Fistula gets healed completely and it do not recur. Pt. maintains his normal routine life during treatment period. Sitz bath can be beneficial: This involves sitting in a tub filled with warm water so that the affected site is submerged. An antiseptic and astringent agent like Triphala decoction may be added to the water if needed. A sitz bath soothes the skin and provides relief from pain. This also helps keep the area clean and thus reduces chances of infection. Oily and spicy foods should be avoided: When dealing with anal fistulas, you should try and take a diet that keeps your stool soft and regular. Hence use of oily and spicy foods should be reduced. Eat plenty of fiber and drink lots of water. Alcohol should also be avoided. Comparative Study: Ksharsutra vs Surgery in Anal Fistula Patients- Ksharsutra is done under Local Anesthesia. Hence complications of General Anesthesia are avoided. Surgical procedures are done under GA with all impending complications of General Anesthesia. Ksharsutra being a parasurgical procedure hence no bleeding/ cutting of tissue is involved. Surgery involves cutting/ bleeding. No hospitalization or bed rest is required in Ksharsutra Treatment. In Surgery hospitalization is must. In Ksharsutra; patient can continue his normal daily routine Surgery may require bed rest. Complications like incontinence (inability to hold stool) and recurrence are seen after surgery Ksharsutra is a safe procedure and these complications are not seen. Ksharsutra Treatment is more economical as compared to VAAFT surgery. VAAFT Surgery is comparatively too expensive.
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Fistula-in-Ano - Understanding The Ayurvedic Perspective On It!

Dr. Jainam Shah 91% (84 ratings)
Bachelor of Ayurveda Medicine & Surgery (BAMS), Certificate In Ksharsutra Therapy
Ayurveda, Himatnagar
Fistula-in-Ano - Understanding The Ayurvedic Perspective On It!
Ayurveda takes a holistic approach to treat any disease. It aims to treat fistula-in-ano with a combination of herbs, good lifestyle, healthy diet etc. Ayurveda suggests that fistula occurs due to the disparity of the 3 doshas. The treatment aims at balancing the doshas and healing the condition from within without any side effects. What is anal fistula? Anal fistula is an opening other than the normal opening of the anus. Most people face oozing of stool and pus from the other opening. The surrounding area of the anus becomes painful and tender. If the opening closes for a few days, the pus gets trapped leading to fever and abscess. It is, therefore, important to get rid of the mucus and the pus completely and heal the fistula. In case of multiple openings, modern medicine suggests surgery to get rid of the situation. Ayurveda on the other hand, uses oils, herbs, and other such non-inflammatory means to cure the condition. Digestive fire from the Ayurvedic viewpoint: Digestion only happens smoothly when the Jatharagni/Agni is strong. With natural food and supplements and herbs it is entirely possible to balance the digestive fire. Raw fruits, vegetables, and nuts are the ideal diet to heal this condition. Some foods to avoid to ensure that the aggravation of fistula doesn t take place include aerated drinks, processed foods, milk and milk related products. The herbs that are prescribed by the Ayurvedic practitioner should be continued for at least 3-6 months. Ayurvedic treatment for fistula-inano: Ayurveda has a very precise dosage of herbs mentioned in the ancient books. It is suggested that two tablespoons of Triphala Guggul and 1 tablespoon of Vara Churna should be consumed daily, twice a day, Nirgundi oil should be applied locally every day and 2 tablespoons of curcumin should be consumed daily. Triphala Guggul: This formulation consists of two very important herbs- Guggul and Triphala. Both these herbs helps the body s defence mechanism. This formulation is anti-inflammatory and anti-bacterial in nature. Both the herbs help in toning the gastrointestinal tract, streamline the flow of bile and aids the intestine to effectively eradicate bodily waste. Vara Churna: Vara Churna is a formulation that contains several herbs such as amalaki, bibhitaka, haritaki etc. This formulation helps clean the colon and strengthen the GIT. This formulation is effective for vata, kapha, and pitta. Vara Churna is extremely effective for rectifying constipation, aiding blood circulation improving liver function and balancing the blood pressure. Nirgundi Oil: This oil is made up from the herb Nigundo. This herb is pungent, bitter and astringent in flavour. It is a natural antibiotic and is an anti-inflammatory. This oil can relax the muscles, reduce congestion and pain.
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भगन्दर का ईलाज

Dr. Motilal Sharma 92% (14 ratings)
Ayurveda, Jodhpur
भगन्दर का ईलाज
भगन्दर(fistula in ano.)- परिचय,कारण,लक्षण,चिकित्सा- 1.भगन्दर परिचय (introduction)- -सामान्यतया: रोगी के द्वारा गुदा या मल द्वार से संबधित सभी रोगों को बवासीर या पाइल्स ही समझ लिया जाता है, लेकिन ये जरूरी नहीं है कि मल द्वार से संबंधित रोग पाइल्स ही हो इसमें कई और रोग भी हो सकते हैं। जिन्हें हम पाइल्स समझते हैं। भगन्दर में रोगी के मल द्वार के चारो ओर लगभग 4 cm दूरी पर या तो एक फोडा बनता हैं या एक फुडिया बन जाती हैं जिसमें से पानी या मवाद लगातार आता रहता हैं Fistula means reep or pipe like. It may be defined as a chronic granulating tubular tract consisting of fibrous tissues with two openings communicating between two cavities or cavity to cutaneous surface of body. Thus anal fistula has two openings, one on perianal or perineal skin surface and other in anal canal. भगन्दर कारण (causes)- 1. Anal infection 2. अत्यधिक समय तक बैठना 3. इसके अलावा विभिन्न रोगियो पर किये गये अनुसंधान से ये पता चला हैं कि भगन्दर होने का एक प्रमुख कारण अत्यधिक समय तक दुपहिया वाहन या गाडी चलाना या उसकी सवारी करना भी होता हैं भगन्दर के लक्षण - 1. गुदा या मल द्वार के चारो और किसी फोडे या फुडिया का बनना और उसमें से पानी या पस आना एक या अनेक छिद्र बनना 2. कभी कभी बैठने में दर्द होना 3. मल त्याग में परेशानी होना चिकित्सा - अब तक के क्लीनिक अनुसंधान से ये पता चला हैं कि किसी भी पैथी के मेडिसिनल चिकित्सा से इसको ठीक करना असंभव हैं आयुर्वेदिय क्षार सूत्र चिकित्सा ही इसकी विश्वसनीय चिकित्सा हैं ! आइये चुने.स्वस्थ एवं आनन्दमय जीवन. एल.एन.आयुर्वेद के संग!

Haemorrhoids and Fissure

Dr. Namitha 91% (14 ratings)
Homeopath, Bangalore
Haemorrhoids and Fissure
People generally are not aware of the diseases till they themselves suffer from them. Piles and anal fissures are two different ailments affecting the anal canal and lower rectum. If you are feeling pain in lower rectum or near the anus or if you are having complaints of bleeding while bowel moments, you might be suffering from piles/ haemorrhoids or analj fissure. Symptoms may be same so patients are genrerally not be able to decide whether it is pile or fissure. Only a doctor may diagnose the problems, causes and may render accurate treatments thereof. What is piles or haemorrhoids- Piles are referred as the swollen or inflamed veins in the lower parts of the anus or rectum. Piles may involve swollen blood vessels near the anus forming protrusion to the outside. What is anal fissure? An anal fissure is a small or thin cut in the lining of the anal opening. It may cause bleeding, pain and discomfort while straining or bowel movement. It may occur while passing hard stools during bowel movements. It may affect people of any age. Both the conditions may lead to itching or inability to sit down comfortably. Such problem may make your life miserable and situations may become intolerable many of the times. Sometimes, unawareness may lead to the seriousness of the disease. He or she may open up before the specialist at a later stage when problems can be treated with surgery only. Often traditional methods may fail to recover the situations. Whenever you are suffering from any anorectal problems, one needs to take experts advise and get diagnosed at the real time.

Popular Questions & Answers

Since April, I was under ayurvedic treatment for fissures but had to discontinue due to acidity. I was under impression that ayurveda is safe. Acidity stopped within a week after discontinuing ayurveda. I have relaxed sphincter tone, anal swelling on one side, it shrinks after taking Chirulvilvadi kashaya but acidity stopped from continuing. Mild occasionally rectal pain is there.

Bnchy Wellness Medispa 89% (92 ratings)
Bachelor of Naturopathy & Yogic Sciences (BNYS), in yoga and naturopathy, Bachelor of Ayurveda, Medicine and Surgery (BAMS), Bachelor of Physiotherapy
Ayurveda, Delhi
lybrate-user, for anal fissures and fistula the most important thing more than a medicine is the food. You should completely avoid spicy, hot and sour food. Ad curry leaves, fibre food to your diet. 1 glass of water + half glass of milk + 3 small onions - boil it and and then grind it in mixi and have it on empty stomach. Elephant yam is good for fissures. You can do sitz bath. Sit in luke warm water mixed with little salt for half hour take more fruits and fruit juices. Chiruvilwadi kashayam is very good for fissures. Check your diet and take kashayam regularly.
1 person found this helpful

I have found that I am suffering from Anal fissure. I think it is because passing hard Stool. It goes on its own and comes back again and again. What should I do to eradicate this problem?

Dr. Vaibhav Kapoor's 90% (124 ratings)
MBBS, MS - General Surgery, FIAGES
General Surgeon, Gurgaon
Hi Anal fissures can be really painful and troublesome. Constipation is one of the most important causes of this problem .conservative measures like taking laxatives ,sitting in warm water and eating high-fibre diet will solve your problem temporarily. Laser treatment of Anal Fissure will help you solve your problem immediately and not cause recurrence. Post laser treatment you will be on proper diet (diet chart will be provided) and you will be taught pelvic floor exercises which will help strengthen pelvic muscles and avoid constipation in long-term. Laser treatment is the 10 minute painless procedure with no dressings in post-operative period .we do it very regurarly at Gurgoan and with excellent results.
1 person found this helpful

Sir, I trouble fissure. If I eat spicy and do hoteling occasionally do drinks thereafter I suffer constipation and bleeding. It happens 1or2 months gap. I tired. I'm vegetarian.

Dr. S K Singh 87% (109 ratings)
M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
You should take mild laxatives like Triphal Churna/ Haritaki Churna etc. Increase Fiber diet like green leafy vegetables and salad etc. Increase liquid intake specially butter milk Increase physical activity like morning walk etc. Take hot water tub bath and apply coconut oil in anal passage.

How much chances of a reoccurring anal fissure after surgery of a chronic anal fissure.

Dr. Sunil Kumar 89% (66 ratings)
Ayurveda, Hisar
Dear user Recurrence is depends on the operative procedure.In ksharshutra Surgery success Ratio is about 98%.You may Consult me For Fissure ,Fistula in Ano, Piles & Other Anorectal Disorders& Digestive System Disorders Include all Chronic Disease of Our Body.
1 person found this helpful

I am suffering from Anal fissure from last 3 days. Their is swelling in one side of area from where the stool pass, that is too much pain full I am not able to sleep properly. So I am using pain killer Aceforce sp and antibiotic oneclav 625. A small amount of blood is coming during bowell moment because I am taking creamafinn at night. How to cure it fast?

Dr. Garima Sharma 92% (391 ratings)
General Physician, Fatehabad
Hi lybrate-user, You need to control your symptoms as well as treat the main cause such as constipation. Here are some home remedies to give you relief: 1. Exercise adequately: Leading an active life is another important step of treating anal fissures. You must exercise moderately for atleast 30 minutes every day. This will help in strengthening the muscles and also avoid constipation. In addition to exercising, you should also practice yoga and deep breathing. Yoga which is especially targetted at the pelvic organs help in maintaining a proper bowel system. Deep breathing and meditation help in reducing stress, which in turn help in solving stomach related problems and constipation. All this helps in curing anal fissures and also prevent re-occurence. 2. Fruits and Vegetables: Eating the proper food is very important to cure anal fissures. A diet consisting of fresh fruits and vegetables should be followed for atleast two weeks after the problem is completely solved. Fruits like oranges, papayas, apples, bananas and guavas should be consumed which aren’t heavy for the stomach to digest and easily pass in stools without causing any trouble. You can also opt to have fresh fruit juice or vegetable juice, as these also help in cleansing the system. 3. Olive Oil: This is useful if you directly apply to the rectum skin. Apply some olive oil to the skin around the anus before passage of stools. This will help soften the stools as they are being excreted and the patient will feel less of pain and no discomfort at all. 4. Warm Water Tub: Use a tub filled with warm water and sit inside for atleast 20 minutes in the morning. This will help in healing the torn skin and tissues. Warm water also helps in relaxing the internal anal sphincter. Repeat this in the evening and night as well. You can also have a warm shower, but this will not help directly. Remember never to separate the buttocks as this will slow the process of healing. 5. Drink Water: Water helps to cleanse the system as well as provide a good functioning capability to the digestive system. Keeping yourself hydrated can help you soften your stools and that won’t cause you any discomfort during passage of stools. Hope this helps. Good Luck.
2 people found this helpful

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