Anal Fissure Tips

A tear in the anal canal is called anal fissure. When the skin breaks, it can cause pain and extreme discomfort. Some amount of bleeding during defecation may also be experienced. When the anal aperture is over-strained, it results in a crack leading to fissure. In women, delivery trauma can lead to anal fissure. Ulcer in the anal canal or sexually transmitted diseases too can cause the anal fissure. In children, it is commonly due to injury by passing hard stool. Fissure is usually seen at the anal verge. This being a highly sensitive area; any scratch or tear in this area gives excruciating pain, burning, itching, irritation like symptoms. There may be spasm in the anal region (which is a protective mechanism) and the patients are scared of passing stools. Sometimes patient avoids eating food so as to avoid going to toilet. Usually the pain subsides in an hour or so. However in some conditions where there is underlying inflammation and infection; the pain may persist whole day. Recurrent anal fissure which has not been treated properly give rise to an extra skin growth known as sentinel tag. 

Ayurvedic remedies: In the patient suffering from Anal fissure; it is very important to regulate the bowel habits properly. Some mild laxatives may be used to soften the stool. Hot sitz bath and use of some soothing ointments, coconut oil, ghee etc. are helpful as they avoid the irritation. Ayurveda can completely cure the people suffering from anal fissures. The treatment duration differs from one individual to another. This is also based on the severity of the disease. In acute anal fissure; the allopathic doctors usually recommend surgery. The commonest adverse effect of surgery is incontinence where the patient is unable to hold stools. However acute anal fissure can be treated without surgery very effectively using Ayurvedic Kshar Karma. In this therapy; certain medicines are applied in the anal fissure so as to promote the healing. The sittings are repeated after weekly intervals and fissure heals in 3-4 sittings. In this way; this is highly specific, very effective and convenient method of treating anal fissure. In chronic anal fissure with associated Sentinel tag; Ksharsutra ligation is used to remove the tag followed by Kshar Karma sittings. In case you have a concern or query you can always consult an expert & get answers to your questions!

If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.

So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.

What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.

What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.
 

 

Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.

For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.

Treatment options
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.

Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly. In case you have a concern or query you can always consult an expert & get answers to your questions!

The area in and around anal region is some time affected with pain swelling and pus or watery discharges. This abnormal presentation may be due to anal fistula. It is characterized by a nodular swelling in or around anal region with occasional pain and watery or blood mixed pus discharge. The symptoms might be mild but as the time passes the fistulous tract may become deep and develop multiple branches with multiple openings. This makes the treatment more difficult. Therefore it is always advisable as soon as this condition is diagnosed it should be treated promptly to avoid further complications. 

Causes: The causes of anal fistula are many. The major reason is the formation of pus. Incompletely cured abscess, microbial infection, ulcers, inflammation of anus and the region around it, and complications that arise out of a surgery can cause the anal fistula. The individuals suffering with diabetes, ulcerative colitis, malignancies and also individuals undergoing chemo or radiotherapy or having some other immune compromised conditions are prone to develop anal fistula. 

Treatment: Practically it has been noticed that any amount of oral medications either from allopathy/ homeopathy or Ayurveda is not of much help. In allopathy the surgeons usually advice Fistulectomy i.e. complete excision of fistulous tract or VAAFT – Video Assisted Anal Fistula Treatment. However in both these case a fairly high incidence of recurrence has been noticed. In Ayurvedic surgery; Fistula has been categorized among eight diseases which are difficult to cure. A highly specific Ksharsutra procedure has been advised in Ayurvedic surgery to treat this problem. Subsequently, efficacy of this Ksharsutra therapy was compared with surgery in 1991. This clinical trial was conducted by Indian Council of Medical research at AIIMS New Delhi and PGI Chandigarh. They have clearly reported that Ksharsutra treatment is more convenient and more effective as compared to surgery in the patients of Anal fistula. The recent concept of Graded Ksharsutra has further improved the efficacy of this therapy. Facility of Graded KsharsutraTM is available only at Sushruta Ano rectal Institute Rohini; New Delhi. 

Ksharsutra Therapy: It is a highly specific and most effective amongst all available treatments for the patients of Anal Fistula. In this treatment; the first step consists of proper identification of fistulous tract with respect to depth, direction and branching pattern. This is usually achieved by careful probing or taking the help of MRI Fistulogram, Ultrasound etc. One the tract has been defined Ksharsutra is placed in the tract with the help of malleable probes under local anesthesia. Since there is no injury to the soft tissue hence no pain or bleeding is expected after this treatment. Patient can continue his routine activities as usual from the very first day. The Ksharsutra – medicated thread is changed at weekly interval. Usually the Fistula heals @ 0.5 to 1 cm per sitting. Therefore the anal fistula which is 4-6 cm long they usually heal in 8-10 sittings. After Ksharsutra Treatment the sphincter control remains normal and the fistula heals completely.

If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.

So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.

What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.

What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.

Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears an d cracks around the anus.

For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.

Treatment options
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.

Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly.
 

A fistula is an abnormal connection between two hollow spaces (epithelial surfaces), such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injuries or surgeries resulting in infection or inflammation. Also sometimes fistulae are created for therapeutic purpose.

Types of fistulas include:

1. Blind - with only one open end. Also known as sinus tracts
2. Complete - with both external and internal openings
3. Incomplete - a fistula with an external skin opening, which does not connect to any internal organ

Location:

1. Eye, adnexa, ear, and mastoid process: Lacrimal fistula, carotid cavernous fistula, mastoid fistula, craniosinus fistula, labyrinthine fistula, perilymph fistula, and preauricular fistula
2. Circulatory system: Coronary arteriovenous fistula, arteriovenous fistula of pulmonary vessels, pulmonary arteriovenous fistula, cerebral arteriovenous fistula, arteriovenous fistula, and fistula of artery
3. Respiratory system: Pyothorax with fistula and tracheoesophageal fistula
4. Digestive system: Duodeno biliary fistula, salivary gland fistula, fistula of stomach and duodenum,  gastrocolic fistula, gastrojejunocolic fistula, enterocutaneous fistula, gastric fistula, fistula of appendix, anal and rectal fissures and fistulas, anal fistula, anorectal fistula, fistula of intestine, enteroentral fistula, fistula of gallbladder, biliary fistula, and pancreatic fistula
5. Musculoskeletal system and connective tissue: Fistula of joint
6. Urogenital system: Vesicointestinal fistula, urethral fistula, vesicovaginal fistula, cervical fistula, enterovaginal fistula, and rectovaginal
7. Congenital malformations, deformations and chromosomal abnormalities: Congenital preauricular fistula, Portal vein-hepatic artery fistula, congenital fistula of lip, Congenital fistula of salivary gland, congenital absence, atresia and stenosis of the rectum with fistula, congenital fistula of rectum and anus, congenital fistulae between uterus and digestive tract, and congenital rectovaginal fistula

Causes:

1. Inflammatory bowel disease causes of anorectal, enteroenteral, and enterocutaneous fistulas.
2. Complications from gallbladder surgery can lead to biliary fistula.
3. Radiation therapy, obstructed labor can lead to vesicovaginal and rectovaginal fistulas. Also, vesicovaginal and rectovaginal fistulas may also be caused by rape with foreign objects.
4. Obstetric fistula develops when the blood supply to the tissues of the vagina, bladder (and/or rectum) is cut off during prolonged obstructed labor.
5. Head trauma can lead to perilymph fistulas.
6. Trauma to other parts of the body can cause arteriovenous fistulas.
7. External causes include traumatic arteriovenous fistula and persistent postoperative fistula.

Physical examination: to determine the extent and pathway of the fistula

Treatment:

1. Treatment for fistula depends on the cause and extent of the fistula.
2. Surgery is often required to assure adequate drainage of the fistula. Surgical intervention combined with antibiotic therapy is usually required
3. In some cases, fistula is temporarily covered e.g. cleft palate fistula is treated with a palatal obturator to delay the need for surgery to a more appropriate age.
4. Surgical procedures commonly used are fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining)
5. Filling the fistula with fibrin glue

In case you have a concern or query you can always consult an expert & get answers to your questions!

You would be surprised to know that half the population around the globe suffers from haemorrhoids, more commonly referred to as piles. What’s worse is, most of the sufferers do not want to acknowledge that they have this problem. Either they stay fearful of the surgery or do not want to face the social embarrassment of owning up to the fact or both. But before you steer clear of treatment, know that there is a natural way of curing all the anorectal disorders like fissure, fistula, pilonidal sinus and piles. The Kshar sutra therapy is one such Ayurvedic remedy that offers a comprehensive cure for these diseases through a minimally surgical process.

Kshar Sutra therapy is a standardized, sophisticated and modified version of an ancient treatment process that was described by ancient sages such as Vagbhata and Sushruta. Depending on the extent and severity of the disease, one may have to undergo several sessions of the Kshar Sutra therapy for desired results.

How are piles treated with the Kshar Sutra therapy?
First, the patient is anaesthetized to inhibit the sensation of pain. Then, the pile mass is taken out of the anal orifice with the help of forceps. Afterwards, the doctor makes an incision at the mucocutaneous junction and then it is transfixed with the help of kshar sutra at the base of the pile. This technique helps in local gangrene of the mass tissue of the haemorrhoids, and the mass sloughs off within a week or so. The entire affected area heals typically within two weeks.

How is fistula treated with the Kshar Sutra therapy?
In the treatment, the patient is first anaesthetized with local anaesthesia. After that, a malleable probe is inserted into the external opening of the pilonidal sinus to the surface of the skin. It helps in separating the debris to avoid chances of any infection. Kshar Sutra therapy for fistula helps in destroying and removing unhealthy tissues and promotes healing of the fistula affected track through caustic action. It can cut through the affected tissues without causing any pain and discomfort and lays the track open gradually.

The primary benefit of the Kshar Sutra therapy is that the chances of recurrence of the disease after the treatment are practically nil. On the other hand, in surgical procedures such as fistulotomy, the risks of recurrence and complications are very high. In all these instances, the Kshar Sutra therapy works as an excellent alternative. But to make the treatment successful, it is essential to follow the instructions of the doctor strictly. It is critical to switch to a well-regulated diet rich in fibre, drink a lot of fluids, and refrain from straining the anal muscles at the time of defecation.

In case you have a concern or query you can always consult an expert & get answers to your questions!

If you think fissure and fistula are the same, you are mistaken. While the term fissure refers to the tear of the skin, fistula refers to the abnormal tube-like passages or connections between organs. Fissures get cured with or without treatment in a few days to few weeks, and do not lead to complications. On the contrary, fistulas when left untreated may lead to complications.

So, read on further to know about the distinction, how to recognize the symptoms and avail treatment.

What is anal fissure?
An anal fissure can occur due to various reason, such as prolonged diarrhea, anal sex, vaginal childbirth, rectum cancer, etc. For majority of the cases, it is usually due to constant constipation or strained bowel movements, that tear down the muscles controlling the sphincters to the inner rectum or the anal canal.

What is anal fistula?
Anal fistulas are not tears but abnormal abscesses near the anus, filled with pus. In fistula, a tunnel is formed under the skin which connects these abscesses to the infected glands. Fistulas are usually the results of present or previous abscesses. If ignored or left untreated, one single fistula can lead to the development of a more complex fistula, where the single fistula tract ends up creating multiple openings.

Symptoms of anal fissure and anal fistula
Some of the common symptoms of an anal fissure are excruciating pain in the anal area every time the bowel movement occurs, constant itching or burning sensation in and around the anus, bloody stool and visible tears and cracks around the anus.

For anal fistula, some of the very common symptoms are a throbbing pain in the anus, which continues to increase, difficulty in sitting down for longer period, swelling and redness around the anus, accompanied by skin irritation, discharge of blood and pus, and at times fever.

Treatment options
To completely cure anal fissure and fistula, it is the various surgical options that are the most effective ones. However, when diagnosed in its earliest form, medications like antibiotics, analgesics, and antipyretics can often help. It is solely depending on the location, type, and size or severity of the fistula or fissure, the treatments may vary from person to person and so does the recovery time.

Though, these conditions cannot be cured with dietary changes or exercise, following a healthy diet can boost healthy bowel movement, reducing chances of constipation or diarrhea that results in fissures.
Prevention is always better than cure. Therefore, it is essential that you visit the nearest medical facilities once you notice any signs of fissure or fistula , to avail the right treatment and get relief from the symptoms quickly.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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 in continence. 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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

The human body is an intricate mechanism that functions amazingly. And when there is any trouble it does not fail to show signs of trouble, and all we need to do is, to notice it and solve our problems. This is applicable to all types of health issue, including a perianal abscess.

What is perianal abscess?
The extremely painful condition of anal abscess occurs when one cavity in the anus starts getting filled up with pus. Very often it appears as a painful swelling similar to boil just near the anus. Usually, it appears red in color as well as slightly warm to touch. If the location of the anal abscesses is in the deeper tissue, then it might be less visible and it occurs in people suffering from inflammatory bowel disease.
The worst part is that in certain cases, anal abscesses might lead to more painful anal fistulas. Generally, fistulas occur only if the abscesses fail to heal and break open on the skin’s surface. Therefore, it is important that the abscess heals properly or else it may lead to intolerable pain and may even require surgery.

How do you know if it is a perianal abscess?
The immediately noticeable and probably the most common anal abscess symptom is constant and throbbing pain around the anal area. Swelling accompanies the pain and its rate increases during bowel movements. Various other common signs include bleeding or rectal discharge, constipation, fatigue, etc. Besides swelling or tenderness, the affected individual might also suffer from skin irritation all around the anus.

Patients with deeper abscess might also show symptoms such as chills, fever, malaise, etc. Various reports state that certain people also feel a lump or nodule at their anus’s rim. Facing difficulty while urinating might also be experienced by some people affected by perianal abscess.

What to do if you suspect a perianal abscess?
One must immediately seek medical if they experience any of the above-mentioned signs or symptoms. Clinical evaluation along with digital rectal exam is sufficient for the proper diagnosis. But, in some cases, patients might need other tests to screen for rectal cancer, diverticular disease, inflammatory bowel disease and sexually transmitted infections. Your physician might also suggest for a CT scan, an MRI or an ultrasound.
Just after the diagnosis, a prompt surgical drainage would be carried out by the doctor before the abscess erupts. Deeper or larger abscess might require hospitalization as well as an anesthesiologist’s assistance. In most cases, patients are prescribed certain medications for pain relief just after the procedure. Antibiotics are mainly given to those people who have comparatively weaker immunity or suffer from diabetes.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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 in continence. 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.

In case you have a concern or query you can always consult an expert & get answers to your questions!