People mean many things when they say they have constipation. The infrequent passing of stools, difficulties in voiding, sense of incomplete voiding are all suggestive of constipation. The normal reference range for bowel movements is very varied. Some people have bowel movements three times a day; others, only one or two times a week.

Medically, constipation is defined as fewer than three bowel movements in a week. Constipation may be considered severe when there is less than one bowel movement in a week.

SYMPTOMS-

Infrequent stools with no other complaints are rarely abnormal. Women are more affected than men. The elderly and children are however most prone to constipation. Hard, difficult to pass stools which require straining or manual removal with fingers - felt more than 25% of times. Stools infrequent, less than three times a week.The sensation of incomplete voidance. Other symptoms that a person with constipation may feel are:

The abdomen may seem bloated, distended or crampy.

The bowel sounds may seem enhanced. 

CAUSE-

Many factors contribute to the development of constipation. Different people will have a different set of causative factors.

• Insufficient fiber intake in the diet.

• Not chewing the food properly / eating hurriedly.

• Reduced water intake.

• Various medications

• Iron supplements

• Antidepressants, tri-cyclic anti-depressants.

• Anti-convulsants

• Diuretics

• Stopping cigarette smoking.

• Abuse of laxatives.

• Medications containing calcium and aluminum.

• Endocrine disorders like - underactive thyroid.

• Any severe illness like stroke, paralysis.

• Major changes in life like pregnancy, old-age or traveling.

• Psychosomatic causes like depression and anxiety neurosis.

• Biochemical imbalance ' low potassium levels in the blood.

• Lead poisoning.

Conditions that obstruct the normal passage of the stools within the intestines ' foreign bodies in intestines, strictures, adhesions, tumors, etc.

• Abdominal surgeries.

• Weakened pelvic floor muscles.

• Constipation can occur sometimes as part of a condition called 'irritable bowel syndrome' where it alternates with diarrhea.

TREATMENT-

ALUMINA 30 — Alumina is an effective remedy for constipation when there is the absence of urge for stool. The person needing Alumina has no desire to pass stool for days together until a  large accumulation collects in the intestine. The intestines are highly sluggish and inactive. Stool whether hard, dry or soft needs much straining for it to find its way out. In constipation of bottle-fed babies and infants  Alumina, the best choice of medication.

NUX VOMICA 30 — Nux vomica is one of the top medicines for constipation when frequent, ineffectual urging to stool is present.   In every attempt, the stool passed is scanty and there is a feeling of incomplete evacuation. Shortly after passing the stool, the urge gets renewed. In Cases of constipation from abuse of laxatives  Nux Vomica to be extremely useful. It can also be used in cases where piles develop in association with constipation. Nux Vomica is highly suitable to persons with constipation who have sedentary habits and are not in a habit of regular exercise.

BRYONIA ALBA 30-Bryonia is very effective for constipation when stool is highly dry, large and excessively hard. Bryonia Alba is mainly indicated for all the conditions where mucous membranes are dry to the utmost degree. Along with constipation, the abdomen may appear distended and sore to touch. An increased thirst for large quantities of water with dry mouth and lips may accompany. Along with constipation gastric headache of bursting nature may also appear.

OPIUM 200- Opium is best suited for those cases of constipation where stool is passed as round, hard, black balls like sheep dung. Stool gets retained in intestines for long without having any desire for defecation. Abdomen seems hard and bloated with constipation. Opium is also highly ranked homeopathic remedy for constipation which occurs after the abuse of enemas

SILICEA 200-Silicea is another effective remedy in constipation with painful constriction of the anal sphincter. Stool is passed down the rectum with great straining efforts but due to spasmodic constriction of the anal sphincter, it recedes back. Stool slips back into the rectum after being partly expelled as anus closes upon passing stool. The rectum is also very weak and seems paralyzed. Stool remains in the rectum for a long time. Obstructed flatus is present along with constipation and the abdomen feels tight, bloated, hard and distended.  Silicea offers great help in females who suffer from constipation before and during menses.

CASCARA SAGRADA Q- It is a specific remedy for constipation. Chronic indigestion. Constipation with piles. It is an intestinal tonic and helps remove dyspepsia.

CALCAREA CARB 30- Calcarea carb is a prominent remedy for constipation in children. For it to be indicated the first part of stool is hard followed by soft stool, which too, is passed with great difficulty. Aversion to milk is often present in children needing Calcarea carb. They may also show a desire for indigestible things like chalk, lime, and pencil.

SANICULA 30- Sanicula is indicated when a child passes variable stool with a different character. Sometimes stool is large and painful, while at other times stool crumbles at the verge of the anus and at times stool recede after being partly expelled. In addition to this many a times stool is passed in small, hard balls and even needs to be mechanical removed.

CHAMOMILLA 30- Chamomilla is a much-needed remedy for constipation in children who are irritable, headstrong and obstinate to the utmost degree.

MAGNESIA MUR 30-Magnesia mur. is effective for constipation of infants during dentition. Passes only a small quantity of stool like sheep’s dung.

SEPIA 30 - Sepia is an effective remedy for constipation in pregnancy.  Sepia provides much help when stool is very hard and the need arises for it to be mechanically removed. Constant bearing down in uterus often accompanies constipation for women needing Sepia.

CAUSTICUM 30 — Causticum is another remedy for constipation with piles.  Causticum when large piles are present and they obstruct the passage of stool through the rectum.

HYDRASTIS CAN Q - Hydrastis considered a specific remedy for constipation. Stools are felt in the small intestine but do not come down to the large intestines and anus. Constipation with a sinking feeling in the stomach and dull headache. Enemas and glycerine plugs are useless and do not relieve constipation in this case.

 COLLINSONIA CAN 30 - Collinsonia is effective for constipation during pregnancy. Collinsonia can be used for obstinate constipation- hard, dry, knotty stool -with piles.

NITRIC ACID 30 - Nitric acid is indicated when anal fissure occurs with constipated bowels. It is accompanied with much burning and pain. There is bleeding from the rectum

NATRUM MURIATICUM 30 - Natrum Mur. is used when fissures are present along with constipation. Natrum Mur is used when smarting, tearing and stitching pain at anus is present in the fissure due to constipation. There is the unsatisfactory stool. The nature of the stool is like sheep dung.

PHOSPHORUS 30 - Phosphorus another effective remedy for constipation. The stool is long and dry like that of a dog. There is bright red blood passes along with stool.

PODOPHYLLUM PEL 30 - Podophyllum is very effective for constipation in children. It is prescribed when constipation alternates with diarrhea and colic is present.

PLUMBUM METALLICUM 30 - Plumbum met . is effective for traveler’s constipation who are often changing food, water, and places.

SULPHUR 200 - Sulphur is prescribed when constipation occurs on account of fear of passing the stool because stool is hard, knotty and difficulty to expel, they cause pain in the anus while passing.

Piles, Pilonidal sinus and fissures are all ano-rectal diseases which cause tremendous pain and discomfort. Anal fissure or anal fistula is also popularly called fissure-in-ano. It is a disorder in which a tear develops in the skin which lines the anal opening.

Causes of anal fistula-

1. Hard, dry movement of the bowels
2. Severe constipation
3. Chronic diarrhoea which causes excessive friction in the anal area

Symptoms of anal fistula-

1. Pain during passage of stool
2. Bleeding during bowel movement
3. Discomfort during passage of stool including cramps
4. Issues while passing urine
5. Itchiness in the anal area

Kshar Sutra Treatment for Anal Fissures:
Anal fistula is quite painful and is often wrongly diagnosed as piles. This makes the treatment even more time consuming and less effective. Allopathic treatment involves surgery and drying of the wound. The chances of re-appearance of fissures are high in case of surgery. Ayurveda provides a less painful and more effective cure for fistula. Ayurveda has prescribed kshar sutra treatment for different ano-rectal disorders including anal fissures.

How does kshar sutra treatment work?
Kshar sutra is a para-surgical treatment in which a medicinal thread is used to not only remove the infection but also to heal the wound by promoting growth of healthy tissues. Ayurvedic Kshar sutra treatment for fistula includes the following steps-

1. Preparation of the Kshar sutra or the medicinal thread by coating it with medicinal herbs.
2. Physical examination of the fistula to identify its location and extent.
3. A small cut or incision is made through which the medical thread is introduced into the problem area.
4. The medicine on the thread heals the infection and promotes growth of healthy cells.

Ayurveda promotes an all round treatment of the disorder to prevent its reoccurrence. Fissures can be easily cured using kshar sutra. But, along with it, Ayurveda also suggests a healthy, wholesome diet to make the passage of stool easier and pain free.

An anal fistula, is also called as fistula- in -ano, it is a small channel that develops between the end of the large intestine called the anal canal and the skin near the anus. This is a painful condition, especially when the patient is passing stools. It can also cause bleeding and discharge during defecation.

Genesis of fistula-in-ano
Almost all anal fistulae occur due to an anorectal abscess that begins as an infection in one of the anal glands. This infection spreads down to the skin around the anus causing fistula-in -ano. The anorectal abscess usually leads to pain and swelling around the anus, along with fever. Treatment for anorectal abscess involves incising the skin over the abscess to drain the pus. This is done usually under local anesthesia. A fistula-in-ano happens when there is failure of the anorectal abscess wound to heal completely. Almost 50% of patients with an abscess go on to develop a chronic fistula-in-ano.

Symptoms

1. Pain- Constant pain which gets worse when sitting down
2. Irritation around the anus, like swelling, redness and tenderness
3. Discharge of blood or pus
4. Constipation or pain while evacuation
5. Fever

Diagnosis
A clinical evaluation, including a digital rectal examination under anesthesia, is carried out to diagnose anal fistula. However, few patients may be advised screening for rectal cancer, sexually transmitted diseases and diverticular disease.

Treatment
The only cure for an anal fistula is surgery. The type of surgery will depend on the position of the anal fistula. Most patients are treated by simply laying open the fistula tract to flush out pus, called Fistulotomy. This type is used in 85-95% of cases and the fistula tract heals after one to two months.

1. Seton techniques: A seton is a piece of thread (silk, plastic) which is left in the fistula tract to treat anal fissures. This is used if a patient is at high risk of developing incontinence after fistulotomy.
2. Advancement flap procedures: When the fistula is considered complex, carrying a high risk of incontinence, then this advanced technique is used.

Other techniques like Fibrin glue and Bioprosthetic plug are also used to surgically treat anal fistulas. In the Fibrin glue technique, glue is injected into the fistula to seal the tract, after which the opening is stitch closed. Bioprosthetic plug is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. After this stitches are used to keep the plug in place. 

Whatever the surgical technique, one can experience minor changes incontinence. Patients usually don’t require antibiotics after surgery but have to take pain medication. They may also have to use gauze to soak up drainage from anus. After surgery, patients should seek help if they have increased pain or swelling, heavy bleeding, difficulty in urination, high temperature, nausea or constipation.

Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine).  Anal fistula is a disease for which different methods of treatment have been advocated time to time, even today when we are talking about robotic surgery, this disease has no satisfactory method of treatment in modern surgery. The latest method of video assisted anal fistula treatment (VAAFT) is not satisfactory due to high incidences of recurrence after the surgery. But at Sushruta Anorectal Institute New Delhi; with the help of Graded KsharsutraTM all these patients of complex Anal fistula are being successfully treated.

In Ayurveda about 2000 yrs ago Acharya Sushruta has indicated ksharsutra treatment to treat fistula-in-ano. Late professor P J Deshpandey at the faculty of Ayurveda Institute of Medical Sciences B H U; had done extensive research in this field and established a treatment module to cure this disease. In 1990 Indian council of medical research has clinically evaluated this Ayurvedic treatment module at four premiere institutes in our country including AIIMS Delhi & PGI Chandigarh. Subsequently, it was concluded by I.C.M.R. that in the patients of fistula in ano, ksharsutra treatment is more effective& convenient as compared to modern surgery.

Ksharsutra is a thread coated with certain Ayurvedic medicines known for their antiseptic, debridement & healing properties. After u v sterilization this medicated thread (ksharsutra) is used under complete aseptic precautions in the patients. The patient is routinely investigated with special reference to any other associated disorder like hypertension, diabetes mellitus, tuberculosis etc. The next step lies in the proper identification& evaluation of the fistulous tract. It is mandatory to define the fistula tract wrt its depth, direction & branching pattern. This may be achieved by careful probing under expert hands using malleable probes& if required help may be taken from other investigations like x-ray fistulogram or MRI fistulogram.

Once the tract has been clearly defined the Ksharsutra is placed in it with the help of certain instruments, under local anesthesia. This entire procedure is usually completed in ten to fifteen mins. As there is no cutting of tissues hence no bleeding, no pain & patients can go home after half an hr rest in the daycare room. The medicine-coated on the thread is gradually released in the tract. The cumulative effect of the coated drugs exerts a powerful debridement effect on the fistula tract & induces healing by the fresh & healthy granulation tissues. Thus Ksharsutra is the mechanism of drug delivery precisely at the tissues involved. 

Every seventh or tenth day the old sutra is replaced with a new Ksharsutra till there is a final cut through. It has been observed that the tract heals @ 0.5-1 cm per week. The post-operative complications like recurrence of the disease, fecal incontinence, bleeding is not seen with Ksharsutra treatment. Further, this therapy is performed as an OPD procedure. No general anesthesia & no hospitalization is required. Patient maintains his normal routine activities as usual during the treatment period.  

 At Sushruta Anorectal Institute; Rohini - New Delhi, we have been working on this disease including piles fissures & pilonidal sinus for the last 30 yrs. Here we have developed the concept of Graded KsharsutraTM which has given us a more effective & convenient way to treat anal fistula. At Sushruta Anorectai Institute we have treated on record thousands of patients of anal fistula from different states including overseas patients. We have records to prove that the patients of high anal complex fistula, those have been operated two or three times but failed to heal were successfully treated at this institute.

Anal fistula, a challenge for modern surgery, but can be cured with grade ksharsutra in Ayurveda (Indian system of medicine).  Anal fistula is a disease for which different methods of treatment have been advocated time to time, even today when we are talking about robotic surgery, this disease has no satisfactory method of treatment in modern surgery. The latest method of video assisted anal fistula treatment (VAAFT) is not satisfactory due to high incidences of recurrence after the surgery. But at Sushruta Anorectal Institute New Delhi; with the help of Graded KsharsutraTM all these patients of complex Anal fistula are being successfully treated.

In Ayurveda about 2000 yrs ago Acharya Sushruta has indicated ksharsutra treatment to treat fistula-in-ano. Late professor P J Deshpandey at the faculty of Ayurveda Institute of Medical Sciences B H U; had done extensive research in this field and established a treatment module to cure this disease. In 1990 Indian council of medical research has clinically evaluated this Ayurvedic treatment module at four premiere institutes in our country including AIIMS Delhi & PGI Chandigarh. Subsequently, it was concluded by I.C.M.R. that in the patients of fistula in ano, ksharsutra treatment is more effective& convenient as compared to modern surgery.

Ksharsutra is a thread coated with certain Ayurvedic medicines known for their antiseptic, debridement & healing properties. After u v sterilization this medicated thread (ksharsutra) is used under complete aseptic precautions in the patients. The patient is routinely investigated with special reference to any other associated disorder like hypertension, diabetes mellitus, tuberculosis etc. The next step lies in the proper identification& evaluation of the fistulous tract. It is mandatory to define the fistula tract wrt its depth, direction & branching pattern. This may be achieved by careful probing under expert hands using malleable probes& if required help may be taken from other investigations like x-ray fistulogram or MRI fistulogram.

Once the tract has been clearly defined the Ksharsutra is placed in it with the help of certain instruments, under local anesthesia. This entire procedure is usually completed in ten to fifteen mins. As there is no cutting of tissues hence no bleeding, no pain & patients can go home after half an hr rest in the daycare room. The medicine-coated on the thread is gradually released in the tract. The cumulative effect of the coated drugs exerts a powerful debridement effect on the fistula tract & induces healing by the fresh & healthy granulation tissues. Thus Ksharsutra is the mechanism of drug delivery precisely at the tissues involved. 

Every seventh or tenth day the old sutra is replaced with a new Ksharsutra till there is a final cut through. It has been observed that the tract heals @ 0.5-1 cm per week. The post-operative complications like recurrence of the disease, fecal incontinence, bleeding is not seen with Ksharsutra treatment. Further, this therapy is performed as an OPD procedure. No general anesthesia & no hospitalization is required. Patient maintains his normal routine activities as usual during the treatment period.  

 We have been working on this disease including piles fissures & pilonidal sinus for the last 30 yrs. Here we have developed the concept of Graded KsharsutraTM which has given us a more effective & convenient way to treat anal fistula. At Sushruta Anorectai Institute we have treated on record thousands of patients of anal fistula from different states including overseas patients. We have records to prove that the patients of high anal complex fistula, those have been operated two or three times but failed to heal were successfully treated at this institute.

An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements. You also may experience spasms in the ring of muscle at the end of your anus (anal sphincter).

Anal fissures are very common in young infants but can affect people of any age. Most anal fissures get better with simple treatments, such as increased fiber intake or sitz baths.

Causes

Common causes of anal fissure include:

·        Passing large or hard stools

·        Constipation and straining during bowel movements

·        Chronic diarrhea

·        Inflammation of the anorectal area, caused by Crohn's disease or another inflammatory bowel disease

·        Childbirth

Less common causes of anal fissures include:

·        Anal cancer

·        HIV

·        Tuberculosis

·        Syphilis

·        Herpes

Symptoms

Signs and symptoms of an anal fissure include:

·        Pain, sometimes severe, during bowel movements

·        Pain after bowel movements that can last up to several hours

·        Bright red blood on the stool or toilet paper after a bowel movement

·        Itching or irritation around the anus

·        A visible crack in the skin around the anus

·        A small lump or skin tag on the skin near the anal fissure

Risk factors

Factors that may increase your risk of developing an anal fissure include:

·        Infancy. Many infants experience an anal fissure during their first year of life; experts aren't sure why.

·        Aging. Older adults may develop an anal fissure partly due to slowed circulation, resulting in decreased blood flow to the rectal area.

·        Constipation. Straining during bowel movements and passing hard stools increase the risk of tearing.

·        Childbirth. Anal fissures are more common in women after they give birth.

·        Crohn's disease. This inflammatory bowel disease causes chronic inflammation of the intestinal tract, which may make the lining of the anal canal more vulnerable to tearing.

·        Anal intercourse.

Complications

Complications of anal fissure can include:

·        Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment.

·        Recurrence. Once you've experienced an anal fissure, you are prone to having another one.

·        A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure.

Homeopathic Remedies

Homeopathic remedies are very effective for curing anal fissure. Some of the important remedies are given below

NITRIC ACID 30-Nitric Acid is one of the top remedies for anal fissure. Nitric acid is prescribed when stitching and tearing pains in the anus, or cutting or stinging pain is experienced by the patient. The stool is hard and is accompanied by bright red blood bleeding from the anus. There are much tenesmus and constriction, and a constant oozing of fetid matter from the parts, with burning rawness and smarting.

RATANHIA 30-Ratanhia is a very effective medicine for the treatment of Anal Fissures. It is prescribed when for long-lasting pains in the rectum with excessive burning that follows stool passage is experienced. Patients often describe the pain as being similar to broken glass or a knife piercing in the rectum. The stool requires much effort to be passed out due to the constricted anus.

GRAPHITES 30-Graphites is prescribed when the persons who are susceptible to eczema. The anus is extremely sore and the stools are covered with mucus, with no tenesmus or constriction. The patient usually obese and overweight. The patient is usually chilly and cannot tolerate cold air or cold weather. It is also indicated when anal fissures occur in women around or just after menopause.

PAEONIA 30-Paeonia is an effective medicine for anal fissure with offensive discharge from the anus due to cracks in it. Paeonia is also the best medicine for violent pains in the anus during and after passing stool. The anus is ulcerated and fissured. Itching and burning usually accompany the fissures. There is much rawness and smarting.

SULPHUR 200-Sulphur is prescribed when the stool is hard and dry, causing tears and immense pain in the anus while passage. The patient is fearful of even going to the toilet as he thinks of the pain that will accompany the passage of stool. The pain is accompanied by burning. Sulphur is also effective for itching in anus due to fissure.

PHOSPHORUS 30-Phosphorus  is effective for painless anal fissures. The patient is usually tall, thin and narrow chested. There is increased thirst and that too for cold water. The patient is unable to tolerate warm water and as soon as the water turns warm in the stomach, it is vomited. This medicine is known to irritate, inflame and cause degeneration of the mucous membranes all over the body. The stool is long, narrow and hard, like that of a dog. The stool may be white and hard too. The patient is very sensitive to light, sound and all sorts of external impressions.

AESCULUS HIPPO. 30- Aesculus is prescribed when severe pain is experienced in the anus following stool passage. The stool is mainly hard and large followed by severe pains. 

SILICEA 30-  Silicea is effective when the discharge contains the pus of offensive odor. The stool is passed with difficulty and straining. The stool comes out partially and then recedes again.

ALUMINA 30- Alumina is another effective remedy for fissures with severe constipation and much straining. The mucus membrane of anus is thickened and swollen.

PLATINA 30-Platina is effective for fissures of the anus with crawling and itching every evening.

LACHESIS 30-Lachesis is effective when the person is constipated, anus feels tight as if nothing could pass through it. There is hammering pain in fissure.

Severe to moderate pain in the rectum during and after bowel movements is an indication of anal fissure. If it is accompanied by bright red stool and an itching sensation around the anus, it is more likely to be fissure than anything else. Fissure is usually treated with sits bath and enhanced intake of fibrous food. If that does not heal the problem, the doctor may go for a surgery. However, surgical intervention of fissures is not always a permanent solution. For permanent solution, patients are now turning to homeopathy. Yes, homeopathy can address the problem at its root and gift you a permanent cure.

What Need to Know About Fissure?

● The problem mostly precipitates due to inflammation and dryness of the mucosal end of the anorectal area.
● Straining during bowel movements and passing hard stools strain the anal mucosa. That is likely to result in fissure.
● People suffering from chronic diarrhoea are also likely to suffer from this problem.
● People suffering from some kind of inflammation of the anal area due to diseases like Crohn's disease or some kind of inflammatory bowel disease may also suffer from fissure.
● The patient may feel a lump in the area surrounding the anus.
● He or she may also experience spasms at the end of the rectum.
● Even infants may suffer from this problem.
● Many women suffer from fissure after childbirth.

Homeopathic Treatment of Fissure

● Homeopathy is known to address diseases to their roots.
● In case of fissure, homeopathic medicine can address the problem by preventing and treating dryness and inflammation of the palpable mucosal area around the anus. If this area is moist, it can stretch better in response to straining during bowel movements and thereby prevent tearing.
● Since constipation is one of the main causes of fissure, homeopathic doctors may prescribe medicines for preventing constipation too.
● However, homeopathic medicine is not a one-size-fits-all remedy. The medicine depends on the constitution of body. The doctor may try to judge body constitution of the patient by asking him questions about sleep pattern, food habit, emotional state, working schedule, etc. The doctor needs to take all these into consideration to prescribe the most appropriate medicine.
● A homoeopathic doctor first gets a conventional diagnosis. If fissure is confirmed in the diagnosis, the doctor may launch an all out attack on the problem so that the problem can be nipped in the bud.

Anal fissure is a painful condition that is mostly precipitated by straining during bowel movements and passing hard stools. Homeopathy can offer permanent solution to this problem by preventing constipation on one hand and preventing as well as treating inflammation and dryness of the anal mucosa on the other hand.

A general surgeon has special expertise in abdomen problems and general anatomy. Best General Surgeons in Gurgaon are specialised in treating trauma surgeries and surgeries related to organs,  gallbladder, colon, appendix bones. Below is the list of best general surgeons in Gurgaon:

1. Dr. Ashish Pitale

MBBS, MS - General Surgery

Consultation fees: ₹500 - 900

Dr Ashish Pitale is a Senior Consultant Surgeon with 27 years of experience. He specializes in Laparoscopic Surgery and has also done a fellowship in Bariatric surgery. He is trained from UK for higher surgical training where he got hands on experience in Gastrointestinal, Laparoscopic, Thyroid and Breast surgery. He currently practices at Columbia Asia Hospital, Gurgaon and his own clinic in Dwarka, Delhi. In his vast experience he has traveled several complicated cases. 

2. Dr. Vaibhav Kapoor

MBBS, MS - General Surgery, FIAGES

Consultation fees: ₹700

Dr. Vaibhav Kapoor has over 10 years of experience in the field of laparoscopic and laser Surgeon. He is also a certified in Laser Proctology and Varicose Veins Surgery. He is known for use of latest technology to treat his patients and is holistic in his approach. He currently practices at Pristyn Care Laser Clinic. His areas of expertise are laser treatment of piles, fistula, fissure, varicose vein treatment. 

3. Dr. Gaurav Bansal

MBBS, MS-General Surgery , FMAS, FIAGES

Consultation fees: ₹500 - 700

Dr. Gaurav Bansal is amongst the best Laparoscopic and General Surgeon in Gurgaon. He is associated with many hospitals like Primus Hospital- Delhi, C K BIRLA , Artemis Hospital, W Pratiksha and Greenwoods Health Centre. His special interest are doing laparoscopic surgeries related to Gallbladder, Hernia, Piles surgery, Fistula, Fissure, Hydrocoele, Gastro Intestinal Surgery , all minor surgeries and Breast surgery. 

4. Dr. Rusy Bhalla

MBBS, MS - General Surgery

Consultation fees: ₹1200 

Dr. Rusy Bhalla is a well known General Surgeon who is practicing from 28 years in these fields. He is currently associated with W Pratiksha Hospital, Gugaon. During his career he has earned various fellowships at national and international level. He is also a member of various medical associations. His area of specialisation are Fistula Treatment, Colorectal Surgery, Thyroid Swelling, G.I. Surgery and Cancer Surgery etc.

5. Dr. Vikrant Sharma

MS - General Surgery, MD - Physician, FNB In Minimal Access Surgery

Consultation fees: ₹300 

Dr. Vikrant Sharma is a well known laparoscopic surgeon and is currently director of advanced laparoscopic surgery centre at Meenakshi Hospital, Kaushambi. He has Done Fellowship In Bariatric Surgery from Mohak Bariatrics and robotics, Indore which is amongst the most reputed center for obesity surgery. He has also specializes in all kind of minimal access procedures like Bariatric surgeries, Colorectal, Gynecological and Gynae-oncosurgeries. 

6. Dr. Avaneesh Hasiza

MBBS, DNB - General Surgery, MS - General Surgery

Consultation fees: ₹500 

Dr Avaneesh Hasiza is amongst the reputed laparoscopic surgeon in Gurgaon. He has more than 15 years of experience and has conducted several hundred surgeries. His area of intrest are removal of gallbladder stone,all types of hernia, abdominal tumours and obstruction surgeries. He is known for the use of the most advanced and best techniques called MIPH or Stapler Piles Surgery for treating appendix and piles surgery. 

7. Dr. Rajiv Parakh

FRCS, M.B.B.S., MS (Surgery)

Consultation fees: ₹1200

Dr. Rajiv Parakh is a General Surgeon who has 36 years of experience. He has been awarded several awards and has been honoured by several institutes like Sushil Malik Oration - Indian Medical Association, SDB Prof. Hari Vaishnava Oration By Delhi Medical Association, Sushil Malik Oration by Indian Medical Association. He is the founder member of Vascular Society of India, Endovascular Intervention Society of India and is a Life Member of the Society of Vascular Surgery. He was elected as Secretary of the International Society for Vascular Surgery, New York, USA in 2007. He currently practices at Medenta hospital. His areas of specialization are Carotid Surgery, Endovascular Surgery, Below the Knee Angioplasty and Vascular Trauma.

8. Dr. A.K. Kriplani

MBBS, MS - General Surgery

Consultation fees: ₹1000

Dr. A.K. Kriplani has 41 years of experience and has held some very reputed positions like President and trustee of the Indian Association of Gastrointestinal Endosurgeons. He is recipient of more than 20 Awards, honours and orations. He is also the first surgeon in India to perform advance surgeries like laparoscopic adrenalectomy, laparoscopic splenectomy and laparoscopic whipple's pancreaticoduodenectomy. He has trained hundreds of surgeons in laparoscopic surgery from India and across different countries.

Treatment of Fissure

Homeopathic Treatment of Fissure
Acupuncture Treatment of Fissure
Psychotherapy Treatment of Fissure
Conventional / Allopathic Treatment of Fissure
Surgical Treatment of Fissure
Dietary & Herbal Treatment of Fissure
Other Treatment of Fissure
What is Fissure
Symptoms of Fissure
Causes of Fissure
Risk factors of Fissure
Complications of Fissure
Lab Investigations and Diagnosis of Fissure
Precautions & Prevention of Fissure
Treatment of Fissure

Homeopathic Treatment of Fissure

Homeopathy has many medicines to relieve the uneasiness of Fissure. Homeopathic medicines are basically aimed at improving or increasing the healing process of the fissures. Following are some homeopathic remedies for fissure :-

Tarentula hispanica
Graphites
Nitric acid
Ratanhia
Paeonia
Silicea 

Acupuncture Treatment of Fissure

During the acupuncture treatment, patients were not allowed to eat sharp and spicy food and also suggested to increase their use of high fiber foods. Acupuncture treatment is very helpful and successful for Fissure diseases. 

Psychotherapy and Hypnotherapy Treatment of Fissure

Psychotherapy can improve the therapeutic possibilities of drugs, diet and surgery. Behavior therapy and psychotherapy may also prove helpful in the treatment of constipation which in turn reduces fissure. Hypnotherapy can be used to quickly relieve stress and other negative emotions. 

Conventional / Allopathic Treatment of Fissure

Allopathic remedy is used for the treatment of fissure or chronic anal fissure. Allopathic remedies reduce anal sphincter pressure, muscle weakness and improves anodermal blood flow which allows the fissure to heal.

Surgical Treatment of Fissure

 Surgical procedure consists of a minor surgical operation to cut in anal muscle. This helps the fissure to heal by preventing pain and spasm. The purpose to cut this muscle, mainly control the bowel movements. The procedure of choice is called lateral sphincterotomy

Dietary & Herbal & Herbal Treatment of Fissure

Take plenty of water and fruit juices
Eat easily digestible food
Eat more vegetables
Eating a high-fiber diet.
Avoid hard foods(i.e. nuts, popcorn and chips)
Avoid to eat non-veg and fatty diet 
Other Treatment of Fissure

Scratching at all costs. You could get sorer and infect the area.
Oily foods, spicy foods, junk foods and fast foods should be avoided.
Drinking alcohol, tea and coffee, and smoking should also be avoided. 

What is Fissure?

An anal fissure is a small tear or cut in the skin lining the anus which can cause pain and/or bleeding. The symptoms of an anal fissure are extreme pain during defecation and red blood streaking the stool. Patients may try to avoid defecation because of the pain. 

Symptoms of Fissure

Pain while passing stools
Blood marked stool
Itching, swelling and irritation around the anus
A visible split or cut in the skin around the anus 

Causes of Fissure

Extreme constipation
Hard dry stool
Diarrhea or Cancer
Chronic use of laxatives
Anus injury
Drug induced
Multiple pregnancies
Risk factors of Fissure
Constipation
Childbirth
Infancy
Older Adults
Crohn’s disease
Sexually transmitted dieases

Complications of Fissure

Piles
Anorectal fistula
Anal Itching
Crohns dieases
Cancer
Anal abscess

Diagnosis of Fissure

Fissures are diagnosed by simple rectal examination. Additional testing may be advised if other medical problems such as inflammatory bowel disease or infections are considered as a cause. 

Precautions & Precautions & Prevention of Fissure

Sitz baths or warm water bath
Cleansing more gently
Avoid sports, such as fast walking and jogging
Avoid using toilet papers.
Avoid Smoking, drinking alcohol and coffee
Follow regular bowel habits
Treat diarrhea or constipation immediately
Maintain the anus clean and hygiene

Anal fissures are small tears that develop in the thin, moist mucosa inside the anus. The most common cause for such a tear is the passage of excessively hard or large stool. Fissures cause pain and bleeding. Anal fissures are common in infants, but older people may also experience the same problem.

Causes of Anal Fissures

1. Passing large and hard stools.
2. Chronic constipation
3. Chronic diarrhoea
4. Childbirth

Uncommon Causes for the Disorder Include-

1. HIV
2. Anal cancer
3. Tuberculosis
4. Herpes
5. Syphilis

Ayurvedic Remedy for Anal Fissure
While fissures can be treated with conventional medications, the use of ayurvedic remedies is considered a much safer avenue of treatment. Here are some ways in which ayurvedic treatment can help cure your problem of fissures.

1. Amalaki- One of the most highly regarded remedies from the school of Ayurveda, Amalaki (Indian Gooseberry) is known as a rejuvenating agent, that helps regenerate the cells. Apart from the host of benefits that amalaki provides, such as acting as an aphrodisiac, amalaki also helps clean the intestine and is used as a form of laxative by people suffering from constipation. Amalaki is also an important ingredient in both Vara churna and Triphala guggul.
2. Haritaki- Another necessary ingredient in Triphala, Haritaki aids in digestion and also enables healthy motion every day. Similar to Amalaki, the ingredient is also used to make Vara churna.
3. Other common ayurvedic ingredients that treat fissures include Vibhitaki, Guggul and Curcumin.

Natural Ways to Treat Fissure
A proper diet and lifestyle are extremely important and complement Ayurveda in the true sense for the treatment of fissures. Here are a few tips for you to follow for naturally curing fissures-

1. Include whole grains in your diet, which are higher in fibre content and help soften your stool.
2. Green leafy and fibrous vegetables, such as spinach and broccoli, must be consumed on a regular basis as they help reduce constipation.
3. Caffeine should be avoided at all cost. This means that you should not drink coffee and sodas.
4. Certain fruits like apples, figs and bananas also help deal with the symptoms of constipation.
5. Lastly, drinking lots of water will help with digestion and will also regulate motion, so that constipation can be avoided.
6. A sitz bath may also help with fissures. To take such a bath, fill the tub with warm water and add iodine, turmeric or neem into the water. Now dip your hip and waist beneath the water and sit for a few minutes.