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Last Updated: Dec 27, 2023

Anal Fissure - Non Surgical Treatment Is Better Than Surgery!

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Dr. S K Singh, Sushruta Ano Rectal Institute Piles And Fistula TreatmentGeneral Surgeon • 37 Years Exp.M.S. (Ayurveda), Bachelor of Ayurveda, Medicine and Surgery (BAMS)
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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.


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.

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