Fissure in Ano

Fissure-in-ano (fish’er) is a condition characterized by a longitudinal crack or slit (ulcer) in the skin of anus. If the skin lining of the lower end of the anus gets scratched, it may break up into a fissure. Fissure-in-ano is observed in children as well as in adults; however, it is more common amongst middle-aged adults.

The posterior midline of the anus is the most common location for fissure due to low supply of blood in this area. Rarely, it can be present on the other areas, such as sides of the anus rather than posterior midline position. Such fissure may be the manifestation of underlying disease e.g. Crohn’s disease, ulcerative colitis etc.

Fissure in ano

Symptoms

  1. Pain while passing stools : The lower anal canal is exquisitely sensitive area of skin and can produce fairly significant signals of pain if damaged. Sharp agonizing knife-like pain starts when the individual passes stool. The pain is severe and persists for an hour or so. It ceases suddenly. The sufferer is comfortable until the next action of bowel. The individual tends to be constipated rather than go through painful ordeal.

    If a fissurebecomes chronic (long-standing) and deep, another kind of pain can develop. It is a dull ache in the anus and pelvis that starts a few minutes after the bowel movement and can persist for hours after passing stools. Thischronic fissure pain is due to spasm of the internal sphincter muscle (one of the small muscles in the anus) and can be quite debilitating.

  2. Severe spasm of the anal sphincter (as a protective reflex)
  3. Blood streaked stool (typically on the side of the hard stool) : It is important to note that the bleeding associated with a fissure-in-ano is bright red and associated with some pain or tenderness in the anus. Dark bleeding of greater amount without any anal tenderness or pain should never be ignored and should be brought to the notice of doctor.
  4. Discharge, swelling, and itching occur especially with chronic fissures
  5. Interestingly, homeopathy has many medicines to relieve the discomfort. Rightly chosen homeopathic medicine covers various aspects of fissure.

Types of Fissure-in-ano

Fissure-in-ano may present as acute fissure of recent origin (less than 6 weeks of duration). At this stage fissures are superficial. Some of them may deepen to reach underlying layers and present as chronic fissureof a long duration (more than 6 weeks of duration) or recurring fissures.

Fissure-in-ano is largely considered as a medico surgical disorder. However, looking at it in the light of homeopathic medicine, it is medically correctible conditions. Fortunately, in most cases, surgery can be avoided with homeopathy treatment.

 Causes 

Most common cause of the fissure-in-ano is constipation. Chronic constipation due to any reason (such as habitual, drug induced, pregnancy, etc.) leads to recurring abrasion or forceful rubbing of the anal mucosa, which leads to a fissure. The current theory also suggests that sphincter spasm and accompanyingischaemia may precipitate the development of fissures and prevent them from healing in some people.

When choosing the homeopathic remedy for fissure, the causative factors are always evaluated, and homeopathic medicine encompassing this cause is chosen. Remedy chosen in such way not only heals the fissure, but also does not allow the problem to recur.

Self HelpFissure in ano 1

  1. Diet – As constipation is the main culprit behind fissure-in-ano, all steps to avoid constipation will help to a great extent. A high-fiber diet and extra fluids to prevent constipation are recommended. This means eating more fruits, vegetables, cereals, whole meal bread, etc. and drinking at least 8 glasses (12 cups) of water a day. Reduced intake of coffee and alcohol also helps.
  2. To relieve pain Apply a warm towel to the area. Warm baths or Sitz baths also relieve pain. Use 8 inches of warm water in the bathtub, 2 or 3 times a day for 5-10 minutes. Do not expose the anal skin to hot bath water or hot shower water. Use only luke-warm water on this area.
  3. Physical activity – No restrictions are necessary. In fact, physical activity reduces the likelihood of constipation.
  4. To prevent infection, gently clean the anal area with soap and water after each bowel movement. Do not put any creams or ointments, cornstarch, talcum or other powder, witch hazel, or anything else on or into the anus.
  5. To prevent recurrence – 1.Avoid constipation by drinking at least 8 glasses of water daily and eating a diet high in fiber. 2.Develop regular bowel habit. Do not suppress desire of passing stools as this results in hard and large stools, which usually produces injury to the anus.3.Avoid straining at stools.4.Avoid anal intercourse.

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