Question

Piles, Fistula And Fissures - How Ayurvedic Remedies Can Help?

Dr.S K Singh, Sushruta Ano Rectal Institute Piles And Fistula Treatment · Accepted Answer

Piles, fistula and fissures are the most common problems affecting the rectum and the anus. Both the rectum as well as the anus has a very rich vascular supply. There could be swelling of these blood vessels or tearing which can lead to the above conditions. Read on to know additional details about each of these conditions.

Piles: In simple words, swollen blood vessels of the anal region are called piles. It can be internal or external, depending on its position inside the rectum or outside the rectum respectively.

Causes:

Chronic constipation, where the person has to strain to pass stools
Increased frequency of motion as seen in dysentery etc.
Increased abdominal pressure like in pregnancy, obesity etc.
Smoking and genetics can also lead to piles.
Symptoms: Starts off as painless bleeding, which happens in the form drops or blood spurts during bowel movement (1st stage); the swelling develops later on. They can continue to grow and may come out of anal canal while passing stool (2nd stage). Later on Pile mass comes out even on sneezing, coughing or standing for prolong time (3rd stage)

Treatment:

In the early stages, once identified, simple Kshar Karma (application of special medicines) is effective..
Diet should be rich in fiber, with fruits and vegetables
Increased water consumption
Ksharsutra Ligation of Pile mass if the disease has reached the 2nd or 3rd stage
Prevention is advised if there is a family history by taking measures like consuming a fiber-rich diet and maintaining hydration, regular exercises. Sphincter exercise etc.
Fistula: When an anal gland gets infected; it may discharge pus around the anal region or inside anal canal. Anal Fistula is characterized by presence of a nodular swelling around anal orifice with on and off discharges. This condition is usually painless however some pain may be noticed in the swelling before the pus discharges. After pus discharge pain and swelling disappears to recur again after some time.

Symptoms:

A constant wet feeling in the anal area, due to pus discharge.
This would be intermittent, and there would be periods with no discharge.
There could be a foul smell due to pus discharge.
Diagnosis and Treatment:

Identifying the exact location is important for Ksharsutra ligation or Surgery/ VAAFT.
An ultrasound scan or an MRI is usually done.
Ksharsutra ligation is a better option as compared to surgery/ VAAFT as the chances of recurrence after surgery/ VAAFT are very high.
Ksharsutra being a non surgical procedure; is more convenient and more effective as compared to surgery. This has already been proved by the scientific trials conducted at AIIMS New Delhi, PGI Chandigarh etc. by Indian Council of Medical Research in 1990.

Graded Ksharsutra is the latest development in Ksharsutra Therapy which is available only at Sushruta Ano Rectal Institute, New Delhi.

Fissures: Fissure is a very painful condition produced due to cracks anywhere in the length of the anal canal usually at the anal verge.

Symptoms

Very painful and the person may not want to go to the toilet
Rarely bleeding is also seen, maybe in very small amounts
Treatment:

Over 90% of the fissures do not require surgery and can be easily managed by Kshar Karma sittings.
Switching to a high-fiber diet and improving hydration will help in managing these symptoms.
Topical relief can be provided by application of medicated oils and paste.
When they are recurrent, a procedure known as lateral sphincterotomy is done. However this procedure is known to have a common complication of fecal incontinence. This is usually seen due to damage to sphincter muscles during surgery or over stretching. Patient is not able to control / hold the stools.
Anal fissure whether acute or chronic can be easily managed by Kshar Karma and Ksharsutra ligation. No surgery or hospitalization is required; and above mentioned complications are also not seen with this highly specific treatment of Ayurvedic surgery.
Though one condition can lead to another, in most people, there is a strong family history and working towards prevention is highly recommended.

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