Fissure

An anal fissure (fissure-in-ano) is a small, oval shaped tear in skin that lines the opening of the anus.This commonly happens because of hard stools during bowel clearance.

• Pain during bowel movement
• Pain after bowel movement lasts up to several hours.
• Bright red colour on the stool or toilet paper after a bowel movement.
• Itching or irritation in your anal region
• Constipation.
• A small lump or skin tag on the skin near the anal fissure.
• A visible crack on the skin around the anus.

1. Decreased blood flow to the anorectal area.
2. Presence of an underlying medical problem: such as Crohn’s disease and ulcerative colitis; anal cancer; leukemia; infectious diseases (such as tuberculosis); and sexually transmitted diseases (such as syphilis, gonorrhea, Chlamydia, chancroid, HIV)
3. Scarring in the anorectal area
4. Overly tight or spastic anal sphincter muscles (muscles that control the closing of the anus)
5. Longstanding poor bowel habits
6. Insertion of foreign objects into the anus
7. Anal stretching
8. Prolonged diarrhoea
9. Straining to have a bowel movement, especially if the stool is large, hard, and/or dry
10. Chronic constipation

According to Ayurveda there are three fundamental energies present in our body: Vata, Pitta, Kapha which should be in balance.Vitiation of the Tridosha (Vata, Pitta, Kapha) causes low or deranged digestive fire leading to constipation. Due to this vata gets aggravated again and causes blockage in downward channels of the body and create minor or a small break in the skin of the anal opening.

Treatment protocol aims at :

1. Giving relief from pain, itching and bleeding which causes extreme discomfort  in fissure.
2. Treating inflammation and healing of the teared skin of the anal canal, prevention of complications and improving overall digestive health and peristalsis so that recurrence of fissure can be prevented.
3. Regular intake of supplements to cure fissure in the form of herbs and herbomineral preparations.

The first line of treatment should always be avoiding/treating  the causative factors. If the problem persists then consider the following treatment protocol.

1. Constipation and Pain during bowel movement - Not enough fluids, fibers and other unhealthy habits makes the stool hard and this leads to constipation causing pain in the rectal wall when you pass a hard stool. In this stage you should manage the condition with Bal haritaki, Sonamukhi and triphala which normalises the intestinal transit time and acts as natural laxatives and also helps to reduce the pain due to hard bowel.

2. Bleeding, pus discharge, itching and irritation- Due to hard stool or straining, the skin of anal opening breaks and causes bleeding leading to infection, Aragvadha, Suranvatak, Amruthadi guggulu, Nagakesara will arrest the bleeding and prevent the attack of secondary microbial infection resulting in pus discharge, itching and irritation.

3. Heal the skin tear around the anal canal with Kamadudha and Suranvatak.

(The above mentioned Ayurvedic drugs are Herbs and Herbomineral preparations)

Other treatments - Sitz bath, Herbal application or kshara, Cauterization, or agnikarma

Triphala,  Sonamukhi, Balharitaki, Aragvadha, Amruthadi guggulu, Kamadudha, Suranvatak, Nagakesara.

If you are experiencing any of the above  signs and symptoms related to Fissure, visit a doctor.